Triage scores for children presenting with mental or behavioral health concerns were inaccurate in two-thirds of cases, according to a recent study published in JAMA Network Open.
Researchers at Ann & Robert H. Lurie Children’s Hospital of Chicago analyzed 74,564 visits for mental or behavioral health complaints among children age 5 to 17 across 15 U.S. emergency departments in the Pediatric Emergency Care Applied Research Network Registry. The study examined use of the Emergency Severity Index, which is used in over 90% of U.S. emergency departments, according to a March 24 news release from the hospital.
Over-triage was found to occur in more than half (57%) of visits, while under-triage occurred in approximately one in 12 visits (8%). The most common diagnoses included depressive disorders (25% of visits), suicide or self-injury (23%) and aggressive behavior (24%).
Under-triage, or assignment of a lower severity score than the level of care that was needed, was found to be more likely among children who were Black, Hispanic and those who expressed a Spanish language preference. Over-triage was also more likely among younger patients and Black patients compared to white patients, according to the release.
The findings highlight potential inequities and accuracy issues in emergency department triage for pediatric mental healthcare, researchers said.
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