Resources and Costs Associated With Repeated Admissions to PICUs
dc.contributor.author | Kane, Jason M. | |
dc.contributor.author | Hall, Matt | |
dc.contributor.author | Cecil, Cara | |
dc.contributor.author | Montgomery, Vicki L. | |
dc.contributor.author | Rakes, Lauren C. | |
dc.contributor.author | Rogerson, Colin | |
dc.contributor.author | Stockwell, Jana A. | |
dc.contributor.author | Slain, Katherine N. | |
dc.contributor.author | Goodman, Denise M. | |
dc.contributor.department | Pediatrics, School of Medicine | |
dc.date.accessioned | 2024-08-12T16:10:38Z | |
dc.date.available | 2024-08-12T16:10:38Z | |
dc.date.issued | 2021-02-17 | |
dc.description.abstract | Objective: To determine the costs and hospital resource use from all PICU patients readmitted with a PICU stay within 12 months of hospital index discharge. Design: Cross-sectional, retrospective cohort study using Pediatric Health Information System. Setting: Fifty-two tertiary children's hospitals. Subjects: Pediatric patients under 18 years old admitted to the PICU from January 1, 2016, to December 31, 2017. Interventions: None. Measurements and main results: Patient characteristics and costs of care were compared between those with readmission requiring PICU care and those with only a single PICU admission per annum. In this 2-year cohort, there were 239,157 index PICU patients of which 36,970 (15.5%) were readmitted and required PICU care during the 12 months following index admission. The total hospital cost for all index admissions and readmissions was $17.3 billion, of which 21.5% ($3.71 billion) were incurred during a readmission stay involving care in the PICU; of the 3,459,079 hospital days, 20.3% (702,200) were readmission days including those where PICU care was required. Of the readmitted patients, 11,703 (30.0%) received only PICU care, accounting for $662 million in costs and 110,215 PICU days. Although 43.6% of all costs were associated with patients who required readmission, these patients only accounted for 15.5% of the index patients and 28% of index hospitalization expenditures. More patients in the readmitted group had chronic complex conditions at index discharge compared with those not readmitted (83.9% vs 54.9%; p < 0.001). Compared with those discharged directly to home without home healthcare, patients discharged to a skilled nursing facility had 18% lower odds of readmission (odds ratio 0.82 [95% CI, 0.75-0.89]; p < 0.001) and those discharged home with home healthcare had 43% higher odds of readmission (odds ratio, 1.43 [95% CI, 1.36-1.51]; p < 0.001). Conclusions: Repeated admissions with PICU care resulted in significant direct medical costs and resource use for U.S. children's hospitals. | |
dc.eprint.version | Final published version | |
dc.identifier.citation | Kane JM, Hall M, Cecil C, et al. Resources and Costs Associated With Repeated Admissions to PICUs. Crit Care Explor. 2021;3(2):e0347. Published 2021 Feb 17. doi:10.1097/CCE.0000000000000347 | |
dc.identifier.uri | https://hdl.handle.net/1805/42738 | |
dc.language.iso | en_US | |
dc.publisher | Wolters Kluwer | |
dc.relation.isversionof | 10.1097/CCE.0000000000000347 | |
dc.relation.journal | Critical Care Explorations | |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 International | en |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/4.0 | |
dc.source | PMC | |
dc.subject | Healthcare costs | |
dc.subject | Intensive Care Units | |
dc.subject | Pediatric | |
dc.subject | Patient readmission | |
dc.title | Resources and Costs Associated With Repeated Admissions to PICUs | |
dc.type | Article |