PMH10 DETERMINANTS, TRENDS, AND COSTS ASSOCIATED WITH 30-DAY ALL-CAUSE READMISSION IN CHILDREN, ADOLESCENTS, AND YOUNG ADULTS WITH SUICIDAL IDEATION USING THE NATIONWIDE READMISSION DATABASE

Abstract

To examine determinants, trends, and costs associated with 30-day all-cause readmission (R) for suicidal ideation (SI) in children, adolescents, and young adults. This was a retrospective cohort study using the 2010-2014 Nationwide Readmissions Database. Discharge records for those aged 5-24 with an SI diagnosis based on the ICD-9-CM code V62.84, were analyzed. Hierarchical models (HMs) were used to assess factors of readmission, length of stay (LOS), and total costs of Rs. There were 197,603 SI index admission (IA) events. Of these, 2% also had a R. The annualized trend of R rates for all age groups remained constant (∼19 Rs per 1,000 IAs). Those aged 13-18 had the highest rate of Rs (∼10 of 19), while I and R mean total costs (MTCs) were highest for those aged 5-12 (IA, $4,546-$5,822; R, $5,361-$7,113). MTCs for the closest Rs were higher than the IAs. The strongest risk factors for increasing R included nonelective admission (aOR=1.36), government insurance (aOR=1.34), and private hospital ownership (nonprofit; aOR=1.30, invest-own; aOR=1.60). The strongest risk factor for increasing the LOS during a 30-day all-cause R included major/extreme severity of illness (SOI) (aOR=1.42). The strongest risk factor for increased total costs during an all-cause 30-day R included nonelective admission (aOR=1.13) and major/extreme SOI (aOR=1.13). The intracluster correlation coefficients for the HMs were 0.06, 0.33, and 0.56 for the R, LOS, and cost model, respectively. Routine annual screening for SI in children with depression younger than 12 should be emphasized and may help reduce readmissions and associated costs.