Boarding Common While Awaiting Acute Pediatric Psychiatric Care

Older age, increasing medical complexity, specific psychiatric disorder were associated with prolonged boarding

By Elana Gotkine HealthDay Reporter

THURSDAY, Feb. 13, 2025 (HealthDay News) — Boarding for pediatric mental health (MH) conditions while awaiting acute psychiatric care is common, with significant variation observed in boarding practice by hospital site, according to a study published online Feb. 13 in Pediatrics.

Kathleen D. Snow, M.D., M.P.H., from Boston Children’s Hospital, and colleagues conducted a retrospective cross-sectional study analyzing pediatric MH boarding encounters at 40 tertiary children’s hospitals between Jan. 1, 2017, and Dec. 31, 2023. The analysis included children aged 3 to 18 years presenting with a primary psychiatric diagnosis.

Data were included for 100,784 boarding encounters across 40 hospitals between 2017 and 2023. The researchers observed an increase in the median length of stay for boarding encounters, from three to four days; 0.3 percent of children had stays longer than 100 days. There was significant variation seen in boarding practices by hospital site. Older age, government insurance type, increasing medical complexity, specific psychiatric disorder, season of presentation, and discharge disposition to home were associated with prolonged boarding.

“Pediatric MH boarding at acute care hospitals is common and patients are increasingly requiring prolonged stays while awaiting psychiatric disposition, especially those with underlying medical and psychiatric complexity,” the authors write.

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