Study finds ED use high before and after self-inflicted injury among youths

The rates of emergency department (ED) use are high before and after self-inflicted injury among youths, according to a study published online Aug. 15 in JAMA Network Open.

Samaa Kemal, M.D., M.P.H., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues conducted a retrospective cohort study of ED encounters by youths aged 5 to 18 years with self-inflected injuries to examine ED use 90 days before and 90 days after self-inflicted injury.

A total of 15,593 ED encounters by youths (median age, 15 years) were identified and included in the analysis. The researchers found that 24.2 percent of youths had an ED encounter within 90 days before an index injury; 71.8 percent of these occurred in general EDs and 38.2 percent were for mental or behavioral health.

Youths with public insurance and those living in rural areas had higher adjusted odds of having an ED encounter within 90 days before an index visit (adjusted odds ratios, 1.77 and 1.31, respectively).

Overall, 26.7 percent of youths had an ED encounter within 90 days after an index injury; 69.2 percent occurred in general EDs, and 47.9 percent were for mental or behavioral health. Higher odds of having an ED encounter within 90 days after an index visit were seen for those with public insurance, living in rural areas, and living in micropolitan areas (adjusted odds ratios, 1.72, 1.21, and 1.29, respectively).

"We found high rates of ED use by youths before and after self-inflicted injury," the authors write. "This finding suggests an opportunity for ED-based interventions, such as suicide risk screening, safety planning, and linkage to services."

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