The prevalence and impact of adolescent hospitalization to adult psychiatric units

AbstractBackgroundWith increasing psychiatric hospitalizations among adolescents and constrained hospital resources, there are times when youth are hospitalized in adult inpatient psychiatry units. Evidence on the prevalence of this practice and associated impacts is lacking.AimsWe sought to explore the prevalence, determinants, and outcomes related to the hospitalization of adolescents aged 12–17 years on adult inpatient psychiatry units in Ontario.MethodsUsing health administrative data, we constructed a cohort of adolescents with an inpatient psychiatric admission in Ontario (2007–2011). We classified adolescents as having an admission to an adult psychiatry unit or to other inpatient units. Multivariable regression models were used to estimate prevalence ratios (PR) for factors associated with adult admission, as well as risk ratios (RR) for the impact of adult admission on length of stay, discharge against medical advice, and 30‐day readmission.ResultsOver the study period, 22.6% of adolescents with a psychiatric hospitalization (n = 16 998) had an admission to an adult psychiatry unit. Older age (16 vs. 15 years: PR = 2.27, 95% CI = 2.07–2.48; 17 vs. 15 years: PR = 2.91, 95% CI = 2.66–3.18), rural residence (PR = 1.46, 95% CI = 1.38–1.55), psychotic (PR = 1.25, 95% CI = 1.15–1.36) or personality disorder (PR = 1.59, 95% CI = 1.41–1.80) diagnoses, and involuntary status (PR = 2.18, 95% CI = 2.05–2.31) were independently associated with adult admission. Adolescents admitted to adult units were more likely to be discharged against medical advice (RR = 1.77, 95% CI = 1.45–2.17).ConclusionsNearly one in four adolescent psychiatric admissions occurs on an adult psychiatric unit. These findings help to fill gaps in the prior literature, and highlight the need for further research to inform policy decisions and resource allocation for adolescent inpatient psychiatric care.

This is the peer reviewed version of the following article: [The prevalence and impact of adolescent hospitalization to adult psychiatric units. Early Intervention in Psychiatry 16, 7 p752-759 (2021)], which has been published in final form at https://doi.org/10.1111/eip.13219. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions: https://authorservices.wiley.com/author-resources/Journal-Authors/licensing/self-archiving.html#3.

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