Trends in resource utilization for new-onset psychosis hospitalizations at children's hospitals

Abstract

Background: Children with new-onset psychosis often require hospitalization for medical evaluation. Objectives: The goal of this study was to assess variations in the management of children with new-onset psychosis and characterize trends in resource utilization. Methods: The study included index hospitalizations for children ages 7–18 admitted to children's hospitals with a primary diagnosis of psychosis from 2011 to 2022 using the Pediatric Health Information System (PHIS) database. Children with a complex chronic condition were excluded. Resource utilization categories included medication, imaging, laboratory, and other clinical resources. Variability in resource utilization was assessed using covariance tests for random intercepts with generalized linear modes after adjusting for age, sex, payor, and severity. Trends in resource utilization were examined using generalized estimating equations adjusting for the same factors and accounting for hospital clustering. Results: Our data set included 7126 new-onset psychosis hospitalizations from 37 children's hospitals. Teenage males and non-Hispanic Whites were most likely to be hospitalized. There was a significant variation in resource utilization across hospitals in all categories (p