title: Factors associated with high resource utilization in pediatric skin and soft tissue infection hospitalizations.
abstract: OBJECTIVE
  To describe factors associated with prolonged lengths of stay (LOS) and increased charges for pediatric skin and soft tissue infection (SSTI) hospitalizations.
  
  
  METHODS
  This study was a cross-sectional analysis of pediatric SSTI hospital discharges in 2009 within the Healthcare Cost and Utilization Project Kids' Inpatient Database. Outcomes were prolonged LOS (>75th percentile) and increased hospital charges (>75th percentile). Multivariate logistic regression controlling for patient and hospital level factors was conducted for 2009 data to assess associations among variables.
  
  
  RESULTS
  The 75th percentile for LOS was 3 days. Infants had higher odds of prolonged LOS than other age groups (<1 year: 1; 1-4 years: 0.70 [95% confidence interval (CI): 0.64-0.76]; 5-12 years: 0.69 [95% CI: 0.63-0.76]; 13-18 years: 1.01 [95% CI: 0.91-1.10]), as did all minority groups compared with white subjects (black subjects: 1.23 [95% CI: 1.09-1.38]; Hispanic subjects: 1.33 [95% CI: 1.20-1.47]; and other races: 1.30 [95% CI: 1.12-1.50]). Public payers compared with private payers (odds ratio: 1.17 [95% CI: 1.10-1.26]) also had increased odds of prolonged LOS. The 75th percentile for charges was $14 317. The adolescent-aged category had higher odds of charges >75th percentile compared with the age category <1 year (odds ratio: 1.54 [95% CI: 1.36-1.74]). All racial/ethnic minorities had higher odds of charges >75th percentile compared with white subjects (black subjects: 1.38 [95% CI: 1.17-1.62]; Hispanic subjects: 1.90 [95% CI: 1.59-2.26]; and other races: 1.26 [95% CI: 1.06-1.50]).
  
  
  CONCLUSIONS
  Vulnerable populations, including infants, racial/ethnic minorities, and publicly insured children, had higher odds of increased resource utilization during hospitalizations for SSTIs. The findings of this study provide potential targets for future preventive and public health interventions.
authors.affiliation: Sections of Hospital Medicine, Baylor College of Medicine, Houston, Texas.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Lopez
authors.affiliation: Emergency Medicine, Baylor College of Medicine, Houston, Texas ; Infectious Diseases, Baylor College of Medicine, Houston, Texas.
authors.forename: Andrea T
authors.initials: AT
authors.lastname: Cruz
authors.affiliation: Department of Medicine, Baylor College of Medicine, Houston, Texas.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Kowalkowski
authors.affiliation: Academic General Pediatrics, Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
authors.forename: Jean L
authors.initials: JL
authors.lastname: Raphael
keywords: cellulitis and abscess; health service research; public health