TY - JOUR
T1 - Variations in the clinical presentations of children and adolescents at eight psychiatric hospitals
AU - Leon, Scott C.
AU - Lyons, John S.
AU - Uziel-Miller, Nina D.
PY - 2000
Y1 - 2000
N2 - Objective: Clinical presentations of children and adolescents admitted to eight psychiatric hospitals were examined to determine variation in symptoms and severity of illness. Methods: A prospective design was implemented using the Childhood Severity of Psychiatric Illness (CSPI) scale, a reliable measure of psychiatric severity and factors thought to affect decision making about mental health services. The CSPI was completed by mobile crisis workers after interviews with 875 children and adolescents to assess whether hospitalization was appropriate. All the children were wards of the state in Cook County, Illinois, and all were subsequently hospitalized. Results: A factor analysis of the CSPI revealed three distinct factors: caregiver problems, externalizing symptoms, and internalizing symptoms. Children were classified as having mild, moderate, or severe problems or symptoms in the areas covered by the three factors. Chi square analyses revealed that significant variation existed between hospitals in the proportions of children with problems or symptoms in the three factor areas and in the severity of their problems or symptoms. Conclusions: The major finding of variation among the eight hospitals on measures of severity of children's psychiatric illness and caregiver problems empirically supports the importance of adjusting for severity before implementing initiatives to manage performance and outcome across a system of hospitals.
AB - Objective: Clinical presentations of children and adolescents admitted to eight psychiatric hospitals were examined to determine variation in symptoms and severity of illness. Methods: A prospective design was implemented using the Childhood Severity of Psychiatric Illness (CSPI) scale, a reliable measure of psychiatric severity and factors thought to affect decision making about mental health services. The CSPI was completed by mobile crisis workers after interviews with 875 children and adolescents to assess whether hospitalization was appropriate. All the children were wards of the state in Cook County, Illinois, and all were subsequently hospitalized. Results: A factor analysis of the CSPI revealed three distinct factors: caregiver problems, externalizing symptoms, and internalizing symptoms. Children were classified as having mild, moderate, or severe problems or symptoms in the areas covered by the three factors. Chi square analyses revealed that significant variation existed between hospitals in the proportions of children with problems or symptoms in the three factor areas and in the severity of their problems or symptoms. Conclusions: The major finding of variation among the eight hospitals on measures of severity of children's psychiatric illness and caregiver problems empirically supports the importance of adjusting for severity before implementing initiatives to manage performance and outcome across a system of hospitals.
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U2 - 10.1176/appi.ps.51.6.786
DO - 10.1176/appi.ps.51.6.786
M3 - Article
C2 - 10828111
AN - SCOPUS:0034044532
SN - 1075-2730
VL - 51
SP - 786
EP - 790
JO - Psychiatric Services
JF - Psychiatric Services
IS - 6
ER -