Admit or transfer? For children with mental health disorders, hospitals' decision may rest on insurance

The health insurance status of children is linked to whether they are admitted or transferred to a hospital after presenting to the emergency department with a mental health disorder, according to a study published in Pediatric Emergency Care.

The study, authored by researchers from the University of California, Davis in Sacramento, examined the association between a hospital's decision to admit or transfer child mental health cases and the patient's insurance. The researchers analyzed pediatric mental health ED admissions and transfers using the Healthcare Cost and Utilization Project 2014 Nationwide Emergency Department Sample.

Of the 9,081 acute mental health ED visits analyzed, researchers found children without insurance had higher odds of being transferred compared with privately insured pediatric patients. Children with Medicaid also had higher odds of being transfered than children with private insurance.

"Children presenting to an ED with a mental health emergency who do not have insurance are more likely to be transferred to another hospital than to be admitted and treated locally compared with those with private insurance," the researchers concluded. "Future studies are needed to determine factors that may protect patients without insurance from disparities in access to care."

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