PHM 2nd Year Fellow Baylor College of Medicine/ Texas Children's Hospital Houston, Texas, United States
Background: Hospitalizations for behavioral health issues have increased 25.8% over the last 10 years. These hospitalizations are costly, with longer lengths of stay and more frequent need for inter-facility transfers. Due to the national shortage of child psychiatrists many community children’s hospitals may not have this resource. Currently there are a lack of studies on quality of care for this patient population when psychiatry consults have been shown to improve metrics such as cost, length of stay, and overall quality of patient care. Objective: Our aim is to determine the impact of an in-house psychiatrist on the quality of care and cost for patients admitted with a psychiatric illness to a community children’s hospital. Design/Methods: We received IRB approval with a waiver for written consent. Children who were admitted to Texas Children’s Hospital (TCH) community campuses (West Campus and Woodlands Campus) were identified with a primary behavioral health (BH) discharge diagnoses from 2022 to 2024. We used the Children’s Hospital Association mental health disorder codes to identify patients with primary BH diagnosis, which were extracted from electronic medical record's through the TCH's EPIC Data Warehouse. An in-person child psychiatrist was hired at West Campus starting January 2023. We will perform data analysis comparing West Campus metrics before and after January 2023. Additionally, we will compare West Campus to Woodlands Campus; both are comparable community pediatric hospitals, but no psychiatrist is available at Woodlands. Our primary measures are cost and quality of care. Cost metrics include length of stay, avoidable hospital days, cost to the hospital, and cost to the payer. Quality of care metrics include readmission rate, disposition (home, inpatient psychiatric facility, partial hospitalization/ intensive outpatient), psychiatry consult, restraint use, initiation of treatment medications, emergency medication use, and transfer to higher level of care. 2022 Preliminary data has been collected with 2023 to follow and then analysis to be completed thereafter.