Effect of Covid-19 Lockdown on Length of Hospitalization Following Suicide Attempts in Adolescents

ABSTRACT

INTRODUCTION: Mental health related concerns have increased as a consequence of the Covid-19 pandemic. Emerging evidence has suggested that adolescents are at a greater risk compared to other age groups. Frequently, it is hypothesized that suicide attempts have increased following the global pandemic;however, inconsistent data currently exists illustrating the pattern of suicide attempts surrounding the pandemic. Therefore, our purpose was to examine the length of stay (LOS) following pediatric suicide attempts across three phases of the pandemic and the potential associated financial burden. METHOD(S) 1,467 patient encounters from the pediatric ED and PICU with a diagnosis of suicide were retrospectively reviewed. A total of 262 patient records (age 15+/-2 yo, 82% female) were included and grouped based on Covid-19 lockdown (defined as March 2020). Three time periods were demarcated 1-yr pre-lockdown, 1-yr immediately following lockdown, and 2nd-yr following lockdown. A Pearson correlation was conducted between LOS and total cost of care. A 1-way between group ANOVA was used to examine mean differences in LOS. A p-value < 0.05 was defined as significant. RESULT(S) A positive relationship was found between LOS and total cost of care (n=142;r=.743;CI95%=.658-.808). The number of attempts per time period was 80, 93, and 89, respectively. The between group ANOVA indicated there was a significant (F=3.77, p=0.024) increase in LOS following the lockdown. Specifically, pairwise comparisons showed that LOS was greater during the 2nd-yr of lockdown compared to pre-lockdown (mean+/-SEM 1.11 +/- .14 vs. 1.63 +/- .13 days;mean difference =.52, CI95% = .15 - .89). CONCLUSION(S) There was a relationship between LOS and total cost of care such that the more time spent hospitalized resulted in higher cost. While it still remains to be determined to what degree the incidence rate of attempt was affected by Covid-19 lockdown, here we suggest that LOS (and perhaps cost) increased following the lockdown date. Interestingly, there was only a difference between pre-lockdown and the 2nd-yr of lockdown. Therefore, future studies should examine factors contributing to greater LOS, such as access to mental health professionals and bed availabilities at inpatient psychiatric facilities.