Effects, trends, costs associated with readmission in early-aged patients with suicidal ideation

ABSTRACT

Objective

To examine determinants, trends, and costs associated with 30-day all-cause readmission (R) for suicidal ideation (SI) in early–aged patients.

Methods

This was a retrospective cohort study using the 2010–2014 Nationwide Readmissions Database. Discharge records for those aged 5–24 with an SI diagnosis were analyzed. Hierarchical models (HMs) were used to assess factors of R, length of stay (LOS), and total costs of Rs.

Results

There were 197,603 SI index admissions (IAs). Of these, 2% had a R. The annualized trend of R rates for all age groups remained constant. Those aged 13–18 had the highest rate of Rs, while IA and R mean total costs were highest for those aged 5–12 (IA, $4,546–$5,822; R, $5,361–$7,113). The strongest risk factors for increasing R included nonelective admission and private hospital ownership. The strongest risk factors for increasing LOS and cost were major/extreme severity of illness and 30-day all–cause R. The intracluster correlation coefficient for the HMs were 0.06, 0.33, and 0.55 for the R, LOS, and cost model, respectively.

Conclusions

The R rate was highest for those in the 13–18 age group, while the costs were highest for those aged 5–12.

KEYWORDS:

• Cost
• hierarchical model
• intracluster correlation coefficient
• length of stay
• readmission
• suicidal ideation

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewers Disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Author contributions

All authors are accountable and responsible for the reported research and have participated in the concept and design, analysis and interpretation of data, and drafting or revising of the manuscript, and all authors have approved the manuscript as submitted.

Ethics approval and consent

This study did not require consent but was approved by the Institution’s Review Board.

Additional information

Funding

This paper was not funded.