Abstract
BackgroundA hospitalized patient’s length of stay (LOS) can have a significant impact on the performance and operating costs of a healthcare facility. Among pediatric patients, traumatic injuries are common causes of emergency room visits and hospitalizations. In Saudi Arabia, little is known about the burden of pediatric traumas on population health and the healthcare facilities. Therefore, the aim of this study was to investigate the associations between traumatic pediatric injury mechanisms and extended LOS in a trauma center.MethodsData was obtained from the trauma registry. From 2001 to 2018, trauma patients between the ages of 0 and 18 years old with LOSs of > 0 days were analyzed. The independent variable was the injury mechanism, which was classified as follows: falls, burns, drowning, motor vehicle collisions, motorcycle collisions, pedestrian, and intentional injuries. The dependent variable was an extended LOS defined as ≥21 days. A multivariate logistic regression analysis was used to evaluate the associations between the injury mechanisms and an extended LOS.ResultsA total of 5563 pediatric patients were included in this study. Of those, 774 (14%) had extended LOSs. Those patients with extended LOSs suffered more severe injuries than those with short hospital stays as measured by the Injury Severity Score (mean scores: 15.4 vs. 6.8, p < 0.01), the Glasgow Coma Scale score (mean scores: 10.4 vs, 14.0, p < 0.01), and the Revised Trauma Score (mean scores: 9.9 vs. 11.0, p < 0.01). Approximately one half of the patients with extended LOSs were admitted due to motor vehicle injuries. In addition, those patients were almost five times more likely to have extended LOSs than the patients who suffered fall injuries (odds ratio: 4.8, 95% confidence interval: 3.2–7.1).ConclusionsBased on the study results, motor vehicle injuries were significantly associated with extended hospitalizations. Prevention is instrumental for reducing healthcare utilization; therefore, these findings call for public health professionals and policymakers to plan, design, and implement preventive measures to reduce the traffic injury burden. In addition, increased traffic law enforcement, such as the use of car restraints, is warranted to reduce the preventable injuries and improve the overall population health.
Highlights
Hospital quality improvement and cost reduction continue to be some of the most critical issues for healthcare payers, providers, and policymakers worldwide
The analysis revealed that the patients with extended length of stay (LOS) were more likely to be admitted to the intensive care unit (ICU) (75.0% vs. 23.0%, p < 0.01) and more likely to undergo surgery (20.4% vs. 17.0%, p = 0.02) than the patients with shorter stays
The analysis showed that the patients transported via private vehicles were 70% less likely to have an extended LOS than those transported via ambulances (OR: 0.3, 95% confidence interval (CI): 0.2–0.4)
Summary
Hospital quality improvement and cost reduction continue to be some of the most critical issues for healthcare payers, providers, and policymakers worldwide. A patient’s hospital length of stay (LOS) is one of many criteria that are widely used to evaluate a hospital’s performance and operating costs [1]. Extended hospitalizations are associated with increased costs, which place a greater burden on the healthcare system [2]. Previous literature has investigated the causes of extended LOSs; for example, one study in Iran found that age, gender, and injury characteristics were associated with the hospital LOS [4]. A hospitalized patient’s length of stay (LOS) can have a significant impact on the performance and operating costs of a healthcare facility. Traumatic injuries are common causes of emergency room visits and hospitalizations. The aim of this study was to investigate the associations between traumatic pediatric injury mechanisms and extended LOS in a trauma center
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
