BACKGROUND: Despite increasing pediatric @entity146 , data are lacking regarding visit characteristics and appropriateness. METHOD: This retrospective cohort study consecutively assessed youngsters aged < 18 years between January 1 and December 31, 2002, utilizing data from a 12-page semistructured institutional evaluation form. Appropriateness, severity, acuity, and harm potential of PPERS visits were rated on a Likert scale. RESULTS: Of 1,062 PPERS @entity1 visits (mean +/- SD age: 13.5 +/- 3.1 years, 51.1% male, and 51.2% white), 305 (28.7%) led to hospitalization. Although most @entity1 (68.7%) were in outpatient care, only 21.9% sought and 11.5% completed an outpatient evaluation prior to reaching the emergency room. As many as 34.4% of PPERS visits were somewhat/very inappropriate (optimal care: outpatient evaluation/treatment, even if delayed), 26.6% were somewhat appropriate/neutral (best served by outpatient evaluation/treatment, but timely appointment unavailable), and only 39.0% were fully appropriate. @entity146 were direct emergency room referral from school (P = .0056) or mental health provider (P = .0438) without prior psychiatrist evaluation, or unavailable appointment (P = .0304). Multivariate predictors of inappropriate PPERS visits (r(2) = .296, P < .0001) included current Global Assessment of Functioning score > 48 (P < .0001), absent suicidal ideation/attempt (P < .0001), low harm potential (< 4.4, P < .0001) and severity (< 4.8, P = .0136) (1- to 7-point scale) of presenting complaint, and absent @entity716 (P = .0008). CONCLUSIONS: Over one third of PPERS visits were inappropriate, characterized by better functioning, low harm potential or severity of presenting complaint, and absent suicidality or @entity716 . Development of and improved access to urgent @entity1 and adolescent @entity146 outpatient care services in the community and referral agent educational programs may minimize inappropriate PPERS visits.

Frequency and XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'child'] @entity716 :: ('MESH:D011605', 'Disease') :: ['psychosis'] @entity146 :: ('MESH:D001523', 'Disease') :: ['psychiatric', 'Main reasons for inappropriate PPERS visits', 'psychiatric emergency room service (PPERS) visits']
@entity146 :: (MESH:D001523,Disease) :: ['correlates of inappropriate pediatric psychiatric emergency room visits']
