title: Trends in resource utilization for hospitalized children with skin and soft tissue infections.
abstract: OBJECTIVE
  To describe trends in national resource utilization for pediatric skin and soft tissue infection (SSTI) hospitalizations.
  
  
  METHODS
  This was a cross-sectional analysis of hospital discharges from 1997 to 2009 within the Healthcare Cost and Utilization Project Kids' Inpatient Database for children with isolated SSTIs. Outcomes examined included patient and hospital characteristics, number of hospitalizations, and resource utilization including length of stay (LOS), hospital charges, and performance of incision and drainage (I&D). Trends in resource utilization were assessed by using linear regression in a merged data set with survey year as the primary independent variable. Multivariate logistic regression was conducted for 2009 data to assess factors associated with increased I&D.
  
  
  RESULTS
  The weighted proportion of SSTI hospitalizations among all hospitalizations doubled (0.46% vs 1.01%) from 1997 to 2009. During the same period, patient demographic trends included a shift to increased hospitalizations in infant and preschool-age groups as well as publicly insured children. Mean LOS decreased from 3.11 to 2.71 days. Increased resource utilization included changes in mean charges from $6722 to $11 534 per hospitalization and a twofold increase in I&D (21% to 44%). Factors associated with I&D include young age, African American race, female gender, publicly or uninsured children, and southern region of the United States.
  
  
  CONCLUSIONS
  SSTI is responsible for an emerging increase in health services utilization. Additional study is warranted to identify interventions that may effectively address this public health burden.
authors: Sections of Hospital Medicine, Department ofPediatrics, Baylor College of Medicine, Houston, Texas, USA. malopez@texaschildrens.org
authors: Michelle A
authors: MA
authors: Lopez
authors: Andrea T
authors: AT
authors: Cruz
authors: Marc A
authors: MA
authors: Kowalkowski
authors: Jean L
authors: JL
authors: Raphael
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends*; D017722:Hospital Charges / Q000639:trends*; D006760:Hospitalization / Q000191:economics / Q000639:trends; D006801:Humans; D007223:Infant; D008297:Male; D010351:Patient Discharge / Q000191:economics / Q000639:trends*; D018461:Soft Tissue Infections / Q000191:economics / Q000628:therapy*; D013207:Staphylococcal Skin Infections / Q000191:economics / Q000628:therapy*