556 Hospital Length of Stay for Patients with Small and Medium Burns Impacted by Distance to Burn Center

Abstract

Abstract Introduction Understanding contributors to patient length of stay is critical for burn center resource management and efficiency. In this study, we analyzed how distance from patient homes to a burn center impacts hospital length of stay. Methods Under IRB approval, we reviewed our trauma registry for burn patients admitted to a regional burn center from 2011 to 2018. Inclusion was limited to patients from the burn center state. Patients were grouped by distance from the home zip code to the burn center (≤100 and >100 miles) according to what might be ground or air transport. Chi-square and Mann-Whitney tests were used to determine differences between groups by race, burn size (TBSA), hospital length of stay (LOS), LOS/TBSA, mortality, and disposition to home. Burn size was categorized by TBSA into small (0–20%), medium (21–50%) and large (51–100%) burns. Results Our study population was predominantly white, non-Hispanic males. Mean burn size was significantly higher in patients who traveled more than the >100 miles to the burn center (Table). Mean LOS/TBSA was not significant between the two groups. However, controlling for burn size, patients with small and medium burns that lived farther from the burn center had significantly longer hospital stays. There was no significant difference in length of stay for patients with large burns, mortality or disposition to home between the two distance groups. Conclusions At a burn center with a large catchment area, patients with burn size < 50%TBSA who lived more than 100 miles from the burn center had significantly longer hospital stays than those who lived closer to the burn center. This may indicate that patients who are referred to a regional burn center for care of smaller burns may require care beyond the level of their local hospitals. It is worth noting that using burn size as an indication of complexity of care may be misleading as body site location of the burn (e.g. hand, face or feet) impacts the recovery. Applicability of Research to Practice For a burn center that serves patients across a vast region, this investigation might be useful in identifying opportunities to provide care for patients who live far from tertiary burn care.