• Ariella Nadler, Deena Avner, Hnin Khine, Jeffrey R Avner, and Daniel M Fein.
• From the Division of Pediatric Emergency Medicine, Department of Pediatrics, Children's Hospital at Montefiore, Bronx.
• Pediatr Emerg Care. 2021 Jan 1; 37 (1): 131-3.

ObjectiveThe mental health epidemic in pediatrics has resulted in a growing clinical burden on the health care system, including pediatric emergency departments (PED). Our objective was to describe the changing characteristics of visits to an urban PED, in particular length of stay, for emergency psychiatric evaluations (EPEs) over a 10-year period.MethodsA retrospective study of children with an EPE in the PED at a large urban quaternary care children's hospital was performed during two discrete periods a decade apart: July 1, 2003-June 30, 2004 (period 1) and July 1, 2013-June 30, 2014 (period 2). Visit information, including length of stay and demographic data, were compared between groups.ResultsThere was a significant increase in the percentage of PED visits for EPE from period 1 to period 2 (1.1% vs 2.2% P < 0.0001). Overall, the median (interquartile range [IQR]) length of stay for children requiring an EPE increased significantly for all visits (5.3 [3.2-15.4] hours vs 17.0 [6.0-26.0] hours, P < 0.0001), including for patients who were admitted (17.8 [7.4-24.6] hours vs 27.0 [21.0-36.0] hours, P < 0.0001) and for those who were discharged (4.5 [2.8-7.7] hours vs 8 [5-20] hours, P < 0.0001).ConclusionsOver a decade, the percentage of children with an EPE has doubled, with a significant increase in the amount of time spent in the PED. This highlights a continued surge in the utilization of PED resources for EPE.Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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