Objective: To examine determinants, trends, and costs associated with 30-day all-cause readmission (R) for suicidal ideation (SI) in early-aged patients.
Methods: This was a retrospective cohort study using the 2010-2014 Nationwide Readmissions Database. Discharge records for those aged 5-24 with an SI diagnosis were analyzed. Hierarchical models (HMs) were used to assess factors of R, length of stay (LOS), and total costs of Rs.
Results: There were 197,603 SI index admissions (IAs). Of these, 2% had a R. The annualized trend of R rates for all age groups remained constant. Those aged 13-18 had the highest rate of Rs, while IA and R mean total costs were highest for those aged 5-12 (IA, $4,546-$5,822; R, $5,361-$7,113). The strongest risk factors for increasing R included nonelective admission and private hospital ownership. The strongest risk factors for increasing LOS and cost were major/extreme severity of illness and 30-day all-cause R. The intracluster correlation coefficient for the HMs were 0.06, 0.33, and 0.55 for the R, LOS, and cost model, respectively.
Conclusions: The R rate was highest for those in the 13-18 age group, while the costs were highest for those aged 5-12.
Keywords: Cost; hierarchical model; intracluster correlation coefficient; length of stay; readmission; suicidal ideation.