title: Relationship Between Severity of Illness and Length of Stay on Costs Incurred During a Pediatric Critical Care Hospitalization.
abstract: OBJECTIVE
  To estimate the impact of severity of illness and length of stay on costs incurred during a pediatric intensive care unit (PICU) hospitalization.
  
  
  METHODS
  This is a retrospective cohort study at an academic PICU located in the U.S. that examined 850 patients admitted to the PICU from Jan. 1 to Dec. 31, 2009. The study population was segmented into three severity levels based on pediatric risk of mortality (PRISM) III scores: low (PRISM score 0), medium (PRISM score 1-5), and high (PRISM score greater than 5). Outcome measures were total and daily PICU costs (2009 U.S. dollars).
  
  
  RESULTS
  Eight hundred and fifty patients were admitted to the PICU during the study period. Forty-eight patients (5.6 percent) had incomplete financial data and were excluded from further analysis. Mean total PICU costs for low (n = 429), medium (n = 211), and high (n = 162) severity populations were $21,043, $37,980, and $55,620 (p < 0.001). Mean daily PICU costs for the low, medium, and high severity groups were $5,138, $5,903, and $5,595 (p = 0.02).
  
  
  CONCLUSIONS
  Higher severity of illness resulted in higher total PICU costs. Interestingly, although daily PICU costs across severity of illness showed a statistically significant difference, the practical economic difference was minimal, emphasizing the importance of length of stay to total PICU costs. Thus, the study suggested that reducing length of stay independent of illness severity may be a practical cost control measure within the pediatric intensive care setting.
authors.forename: Benson S
authors.initials: BS
authors.lastname: Hsu
authors.forename: Saquib
authors.initials: S
authors.lastname: Lakhani
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Brazelton
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000191:economics*; D007902:Length of Stay / Q000191:economics*; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014481:United States