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Hospital type and location influence discharge disposition of adolescents hospitalized for suicide attempts

The likelihood of an adolescent transferring to another facility after hospital discharge for a suicide attempt appears to be influenced by the geographic location of the admitting hospital and whether it caters to children. According to a study supported in part by the Agency for Healthcare Research and Quality (HS000002), about two-thirds (66 percent) of adolescent hospitalizations for suicide end with discharge to their home; 21 percent with transfer to a psychiatric, rehabilitation, or chronic care (P/R/C) facility; 10 percent with transfer to a skilled nursing facility, intermediate care facility, or short-term acute care facility; and 2 percent with death or departure against medical advice.

Researchers analyzed 2000 data from the Kids' Inpatient Database, a nationally representative database of children's hospitalizations in the United States, to examine transfer to home or another facility among adolescents (aged 10 to 19 years) hospitalized for a suicide attempt or self-inflicted injury. Care for 32,655 adolescents who attempted suicide that year was provided in adult hospitals (83 percent), children's units in general hospitals (10 percent), and children's hospitals (4 percent).

Children's units in general hospitals were 44 percent more likely than adult hospitals to transfer adolescent patients to a P/R/C facility. Patients cared for outside the Northeast were significantly less likely to be transferred to a P/R/C facility. These findings suggest that factors other than the needs of these vulnerable adolescents are driving care, conclude the researchers.

See "Discharge disposition of adolescents admitted to medical hospitals after attempting suicide," by Leonard J. Levine, M.D., Donald F. Schwarz, M.D., M.P.H., Jesse Argon, and others, in the September 2005 Archives of Pediatric and Adolescent Medicine 159, pp. 860-866.

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