Abstract
ObjectivesEmergency departments (EDs) have been increasingly utilized over time for psychiatric care. While multiple studies have assessed these trends in nationally representative data, few have evaluated these trends in state-level data. This investigation seeks to understand the mental health-related ED burden in North Carolina (NC) by describing trends in ED visits associated with a mental health diagnosis (MHD) over time.MethodsUsing data from NC DETECT, this investigation describes trends in NC ED visits from January 1, 2008 through December 31, 2014 by presence of a MHD code. A visit was classified by the first listed MHD ICD-9-CM code in the surveillance record and MHD codes were grouped into related categories for analysis. Visits were summarized by MHD status and by MHD category.ResultsOver 32 million ED visits were recorded from 2008 to 2014, of which 3,030,746 (9.4%) were MHD-related visits. The average age at presentation for MHD-related visits was 50 years (SD 23.5) and 63.9% of visits were from female patients. The proportion of ED visits with a MHD increased from 8.3 to 10.2% from 2008 to 2014. Annually and overall, the largest diagnostic category was stress/anxiety/depression. Hospital admissions resulting from MHD-related visits declined from 32.2 to 18.5% from 2008 to 2014 but remained consistently higher than the rate of admissions among non-MHD visits.ConclusionSimilar to national trends, the proportion of ED visits associated with a MHD in NC has increased over time. This indicates a need for continued surveillance, both stateside and nationally, in order to inform future efforts to mitigate the growing ED burden.
Highlights
Emergency departments (EDs) in the US have been increasingly utilized for psychiatric care [1,2,3,4,5,6,7]
Hospital admissions resulting from mental health diagnosis (MHD)-related visits declined from 32.2 to 18.5% from 2008 to 2014 but remained consistently higher than the rate of admissions among non-MHD visits
For ED visits without a MHD-related code, the average age at presentation was 38 years (SD 26.2), 55.8% of visits were from female patients, 17.4% of visits were insured through Medicare, and 12.1% of visits had patients arrive
Summary
Emergency departments (EDs) in the US have been increasingly utilized for psychiatric care [1,2,3,4,5,6,7] This increase in the number of mental health-related ED visits has been demonstrated among adult [1,2,3] and pediatric [4, 6, 7] populations, as well as across individual diagnoses such as depression [8], anxiety [9], substance abuse [10, 11], and suicidal ideation [12,13,14,15]. In order to [1] continue monitoring the situation at the state level, and [2] keep up with nationally published data, there is a need to update the NC-specific information available in the literature
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