Post-intensive care unit pediatric hospital stay and estimated costs.
OBJECTIVE
For pediatric intensive care unit (ICU) survivors, to determine the proportion of hospital stay and estimated hospital costs accounted for by post-ICU care.


METHODS
Prospective study.


METHODS
University teaching hospital.


METHODS
Pediatric patients who survive an ICU admission.


METHODS
None.


RESULTS
Estimated relative daily costs were assumed as follows: ICU, with ventilator/ICU, not on ventilator/intermediate care unit/general pediatric hospital day, at 2:1:0.7:0.3, respectively. Estimated costs were expressed in arbitrary units as (number of days at each level of care) x (relative cost per day). The ICU phase was defined as the patient's first ICU admission only, and the post-ICU phase included intermediate care unit and general pediatric hospital days, as well as ICU readmission during the same hospitalization. Pre-ICU hospital activity was excluded from analysis. For 341 ICU survivors, post-ICU days (median, 4 days per patient) accounted for 62% of the total hospital stay. Post-ICU care accounted for one third of the total estimated hospital costs for ICU survivors. Patients with longer post-ICU stays could not be reliably identified at the time of ICU discharge according to their ICU length of stay, duration of mechanical ventilation in the ICU, age, ICU day 1 mortality probability, or diagnostic group (p>.05).


CONCLUSIONS
Post-ICU care accounts for a substantial proportion of hospital stay and estimated costs for ICU survivors. These observations suggest that developing strategies to optimize hospital utilization at the time of ICU discharge may be important for controlling costs of recovery from critical illness.
Kanter
R K
RK
Department of Pediatrics, SUNY Health Science Center, Syracuse, NY, USA.
D002673:Child, Hospitalized / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005260:Female; D017721:Hospital Costs; D006785:Hospitals, University / Q000191:economics*; D006801:Humans; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay / Q000191:economics*; D008297:Male; D009518:New York; D010360:Patient Transfer; D011383:Progressive Patient Care / Q000191:economics*; D011446:Prospective Studies; D017741:Survivors / Q000706:statistics & numerical data*