529 ARE WE PRODUCING MORE LONG TERM PATIENTS IN NEONATAL INTENSIVE CARE?

Abstract

There is concern that neonatal intensive care practice has resulted in an increased census of chronically ill infants. These infants may limit available acute tertiary care beds and cause staffing problems. We used our computer database to analyze epidemiologic characteristics of ICN admissions from 1976 through 1983. With well-established regionalized perinatal care, admission characteristics have remained relatively constant: 344 ± 45(S.D.)admissions/year, 54.2 ± 6.3% infant referrals, 31.8 ± 3.2% maternal-fetal referrals. There was no trend in the yearly distribution of admissions by birth weight or gestational age. There was no trend to increasing average length of stay (LOS) by year (14.7 days, range 13.4-17.1). Mortality and discharges to community hospitals have varied only slightly (10.7 ± 2.4%, 37.7 ± 3.2% respectively). Discharges directly home decreased from 44.6% to 22.8% while discharges to the pediatric ward increased 3.6% to 11.3% (1976 vs. 1983). Infants with LOS>28 days or to> 38 weeks corrected gestational age accounted for 6.1 ± 1.7% of admissions and 33 ± 9.8% of hospital days. Infants with LOS>12 weeks accounted for 2.3 ± 1.1% and 19.4 ± 10.1% of admissions and hospital days, respectively. While the percentages of hospital days represented by long term infants in 1983 were at the upper end of the ′76-′83 range, there was no trend even if pediatric ward LOS was included. We cannot show an increase in long term babies.