Abstract
Aims & Objectives: Length of stay (LOS) is an important driver of healthcare costs in the Pediatric Intensive Care Unit (PICU). Historically, long-stay patients (LSPs) have been defined as patients whose length of stay in PICU is longer than the 95th percentile. Though small in number, these patients contribute significantly to cost. The aim of this study is to assess the impact of readmissions on the 95th centile of length of stay in the PICU. Methods: Retrospective cohort study of all patients admitted to PICUs in the Virtual Pediatric Intensive Care Unit Systems (VPS) database from January 1st, 2009 to January 1st, 2012. Intercept only quantile regressions were used to estimate 95% level quantiles and their 95% confidence intervals. The quantile estimation was performed separately for each PICU admission which preserved independent individual contributions to quantile estimation. Results: 224, 960 unique patient encounters were identified. The 95th percentile of LOS for all encounters was 16 days. However, as the number of previous PICU admissions increases, the 95th percentile of subsequent PICU admissions increases up to 26 days. In comparison, the median length of stay increased by approximately one day. Table -1: Length of stay with subsequent pediatric intensive care admissionsConclusions: Readmissions have a disproportionate impact on 95th percentile of LOS and significantly adds to hospital costs.
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