OBJECTIVES: To examine determinants, trends, and costs associated with 30-day all-cause readmission (R) for suicidal ideation (SI) in children, adolescents, and young adults.

METHODS: This was a retrospective cohort study using the 2010-2014 Nationwide Readmissions Database. Discharge records for those aged 5-24 with an SI diagnosis based on the ICD-9-CM code V62.84, were analyzed. Hierarchical models (HMs) were used to assess factors of readmission, length of stay (LOS), and total costs of Rs.

RESULTS: There were 197,603 SI index admission (IA) events. Of these, 2% also had a R. The annualized trend of R rates for all age groups remained constant (~19 Rs per 1,000 IAs). Those aged 13-18 had the highest rate of Rs (~10 of 19), while I and R mean total costs (MTCs) were highest for those aged 5-12 (IA, $4,546-$5,822; R, $5,361-$7,113). MTCs for the closest Rs were higher than the IAs. The strongest risk factors for increasing R included nonelective admission (aOR=1.36), government insurance (aOR=1.34), and private hospital ownership (nonprofit; aOR=1.30, invest-own; aOR=1.60). The strongest risk factor for increasing the LOS during a 30-day all-cause R included major/extreme severity of illness (SOI) (aOR=1.42). The strongest risk factor for increased total costs during an all-cause 30-day R included nonelective admission (aOR=1.13) and major/extreme SOI (aOR=1.13). The intracluster correlation coefficients for the HMs were 0.06, 0.33, and 0.56 for the R, LOS, and cost model, respectively.

CONCLUSIONS: Routine annual screening for SI in children with depression younger than 12 should be emphasized and may help reduce readmissions and associated costs.