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Healthcare Cost Associated with an Acute Mental Healthcare Bundle in Pediatric Emergency Departments

Year: 2026

Type: article

Abstract: OBJECTIVE: To evaluate healthcare cost associated with a standardized mental healthcare bundle in two tertiary pediatric emergency departments (EDs) in Alberta, Canada. METHODS: We linked data from the two EDs and administrative health databases. Patients < 18 years presenting with mental health concerns were enrolled during two periods: pre-implementation (standard care) and implementation (mental health bundle). Healthcare resource utilization (HCRU) and costs were compared over 12 months following the initial ED visit. RESULTS: The study included 686 pre-implementation (mean age 12.6 years) and 692 implementation (mean age 13.0 years) patients with similar sex distribution (p = 0.65). Implementation patients had lower admission rates at the index ED visit (4.6% versus 9.8%; p < 0.001). During 1 year of follow-up, implementation patients had fewer hospitalizations (mean = 0.4 versus 0.5; p < 0.001), non-ED ambulatory care visits (mean = 2.7 versus 10.0; p < 0.001), and practitioner claims (mean = 34.3 versus 46.8; p = 0.001). Implementation patients had lower healthcare costs ($12,408 [95% CI $10,336-$14,479] versus $19,326 [95% CI $16,596-$22,056]; p < 0.001) attributable to lower hospitalization ($6845 [95% CI $5257-$8435] versus $9994 [95% CI $8205-$11,782]; p = 0.01), ambulatory care ($1711 [95% CI $1383-$2038] versus $4027 [95% CI $3326-$4727]; p < 0.001), and practitioner ($3851 [95% CI $3410-$4292] versus $5306 [95% CI $4676-$5935]; p < 0.001) expenses during the follow-up. After risk adjustments, care bundle was associated with a 40% [95% CI 26-52%] reduction in mental health-related healthcare costs (p < 0.001) and 37% (95% CI 23-49%) reduction in all-cause healthcare costs (p < 0.001). CONCLUSIONS: Integrating a standardized mental healthcare bundle in pediatric EDs was associated with less healthcare use and cost savings. These findings support its broader use to enhance mental healthcare delivery in emergency settings.

Source: PharmacoEconomics - Open

DOI: 10.1007/s41669-025-00631-w