A multi-site big data analysis of factors impacting the time to disposition in pediatric mental and behavioural health emergency department visits
AI Summary
Pediatric MBH emergency visits have significantly longer time to disposition than non-MBH visits (p < .01).
MBH patients with two or more prior ED visits, and interactions between MBH and repeat visits, significantly prolonged time to disposition (p < .0001).
System and patient factors, including sex, weekend, nighttime, and fall season, significantly influenced TTD, prompting targeted interventions to improve ED performance.
Health Syst (Basingstoke). 2025 Oct 25;15(2):111-124. doi: 10.1080/20476965.2025.2577093. eCollection 2026.
ABSTRACT
The increasing prevalence of mental and behavioural health (MBH) conditions in children has posed significant strain on emergency departments (EDs) to provide adequate and timely care. This study analysed factors associated with time to disposition (TTD) for this patient population. The study utilised electronic health record (EHR) data for pediatric ED visits from 11 ED facilities in South Carolina between October 2017 to March 2023. We identified the MBH patients in our dataset based on ICD-10 codes. In total, 289,721 pediatric ED visits were analysed in a mixed-effects regression model predicting TTD. Male patients (p < .0001), weekend visits (p < .0001), and multiple ED visits (p < .0001) were associated with decreased TTD, but interactions between MBH-related visits and repeat ED visits significantly prolonged TTD (p < .0001) and nighttime and presenting during the fall season also influenced TTD (p < .001). Pediatric MBH-related ED visits have significantly longer TTD than non-MBH ED visits (p < .01). MBH patients with two or more previous ED visits also resulted in significantly longer TTD (p < .0001). Our analysis demonstrated system-level and patient-level factors significantly impact the TTD in an ED. These findings highlight the need to design and evaluate new interventions to improve care for pediatric MBH patients as well as overall ED performance.
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