Psychiatric hospitalization and rehospitalization among children and adolescents: evidence from 10-years electronic records in Beijing, China

Enhancing inpatient services for children and adolescent mental illness is a primary goal of medical systems, yet knowledge of child and adolescent psychiatric hospitalization utilization is limited. This study aimed to characterize hospitalizations and rehospitalizations over a decade and to identify factors associated with rehospitalizations. In this retrospective analysis, we obtained data from the Beijing Hospital Electronic Record Database from January 1, 2013, to December 31, 2022. We analyzed an admission-level dataset (n = 20215 admissions) to describe overall trends and established a patient-level cohort (n = 5048 unique patients) to evaluate rehospitalization risk. Modified Poisson regression models, with variables selected using the Andersen Behavioral Model, were used to identify factors associated with psychiatric rehospitalizations at 30-day, 180-day, and 365-day intervals. From 2013 to 2022, 20215 hospitalizations (involving 17175 unique patients) were analyzed. Mood disorders (50.6%), behavioral and emotional disorders (27.8%), and psychotic disorders (13.3%) were the most prevalent diagnoses. Specialized hospitals served a higher proportion of adolescents (≥ 14 years: 78.6%) and females (60.5%) than general hospitals (P < 0.05). In the readmission cohort(n = 5048), cumulative rehospitalization rates were 9.7% at 30 days, 16.8% at 180 days, and 20.3% at 365 days. Multivariable analysis showed that the psychotic disorders (30-day RR:1.57; 365-day RR: 1.27) and eating disorders (30-day RR:1.91; 365-day RR: 1.56) were associated with significantly elevated risks compared to depressive disorders. Older age (12–17 years) was consistently associated with a higher rehospitalization risk of rehospitalization (P < 0.05). Female patients faced a significantly higher risk of 365-day rehospitalization (RR: 1.15, P = 0.03), sex showed no significant association with shorter-term readmission. Residence status and insurance type did not have significant independent effects in the adjusted models. Psychiatric hospitalizations for children and adolescents in Beijing increased substantially from 2013 to 2022. Rehospitalization risks were primarily driven by diagnostic categories and age. These findings highlight the need for targeted post-discharge monitoring for high-risk diagnostic groups and provide a basis for optimizing pediatric mental health resource allocation in urban settings.