STUDY OBJECTIVE Over the past decade, there has been a dramatic increase in pediatric emergency department (PED) visits seeking mental and behavioral health care. We aimed to determine the relationship between hours of care devoted to patients with mental and behavioral health complaints and markers of PED throughput and timeliness. METHODS We performed a retrospective, single-center, cross-sectional study of PED encounters between 2010 and 2022. We reported effect of care for patients with mental and behavioral health complaints on operational metrics, including 4 throughput metrics and 3 care metrics (eg, vital signs within 30 minutes of arrival or left without being seen rates). We estimated a series of negative binomial regression models with the monthly count of the given metric as the dependent variable and monthly ED volume as the offset. RESULTS We included a total of 720,914 visits over the study period, of which 22,901 (3.2%) were mental and behavioral health complaints. The total number of mental and behavioral health visits increased over the study period, from 1,113 in 2010 to 2,554 in 2021, whereas the median monthly behavioral health care hours showed a 1,483% increase. All outcomes worsened as behavioral health care hours increased in both operational and care categories. CONCLUSION In our single-center study, the increase in mental and behavioral health visits and hours of care was associated with significantly worsened PED throughput and timeliness of care metrics. This relationship highlights the challenges that PEDs face in caring for mental and behavioral health patients while simultaneously providing high-quality care to patients with acute nonmental and behavioral health emergencies.

中文翻译：

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儿科急诊科行为健康就诊、手术和登机的变化。


研究目的 在过去的十年中，寻求心理和行为保健的儿科急诊科 （PED） 就诊急剧增加。我们旨在确定专门用于心理和行为健康问题患者的护理时间与 PED 吞吐量和及时性标志物之间的关系。方法 我们对 2010 年至 2022 年间的 PED 就诊进行了回顾性、单中心、横断面研究。我们报告了对心理和行为健康投诉患者的护理对运营指标的影响，包括 4 个吞吐量指标和 3 个护理指标 （例如，到达后 30 分钟内的生命体征或未被看到的生命体征率）。我们估计了一系列负二项式回归模型，以给定指标的每月计数作为因变量，每月 ED 量作为偏移量。结果我们在研究期间共纳入了 720,914 次就诊，其中 22,901 次 （3.2%） 是心理和行为健康投诉。在研究期间，心理和行为健康就诊的总数有所增加，从 1,113 年的 2010 次增加到 2,554 年的 2021 次，而每月行为健康护理时间的中位数则增加了 1,483%。随着手术和护理类别的行为健康护理时间的增加，所有结果都恶化了。结论 在我们的单中心研究中，心理和行为健康就诊和护理时间的增加与 PED 吞吐量和护理指标及时性的显着恶化有关。这种关系凸显了 PED 在照顾心理和行为健康患者时面临的挑战，同时为急性非心理和行为健康紧急情况患者提供高质量的护理。