Evaluating psychiatric hospital admission decisions for children in foster care: an optimal classification tree analysis.

Department of Psychology, Loyola University Chicago, 6525 N. Sheridan, Chicago, IL 60626, USA.
Journal of Clinical Child & Adolescent Psychology (Impact Factor: 1.92). 04/2007; 36(1):8-18. DOI: 10.1080/15374410709336564
Source: PubMed

ABSTRACT This study explored clinical and nonclinical predictors of inpatient hospital admission decisions across a sample of children in foster care over 4 years (N = 13,245). Forty-eight percent of participants were female and the mean age was 13.4 (SD = 3.5 years). Optimal data analysis (Yarnold & Soltysik, 2005) was used to construct a nonlinear classification tree model for predicting admission decisions. As expected, clinical variables such as suicidality, psychoticism, and dangerousness predicted psychiatric admissions; however, several variables that are not direct indications of acute psychiatric distress, such as the presence of family problems and the location of the hospital screening, impacted decision making in a subsample of cases. Further analyses indicated that the model developed in Year 1 reliably and consistently predicted admission decisions (with 64%-68% overall accuracy) across the next 3 years. Policy, research, and clinical implications are discussed.

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