Long-stay patients in academic children's hospital

Jennifer Maniscalco, Mary Ottolini, Wendy M. Turenne, Kathleen Chavanu, Anthony D. Slonim

Research output: Contribution to journalArticle

Abstract

• Objective: To determine the characteristics and resource utilization associated with long-stay patients in academic children's hospitals. • Study design and methods: Retrospective cohort study using the Pediatric Health Information System database, which includes data from 34 noncompeting children's hospitals in the United States. We defined long-stay patients as those with a length of stay (LOS) 2 standard deviations above the mean. For each discharge, demographic, clinical, and resource characteristics were identified. Chi-square tests, t tests, and logistic regression models were used to test the relationships between these characteristics and LOS for all long-stay patients and separately for neonatal (age ≤ 30 days) and pediatric long-stay patients. • Results: Long-stay patients comprised 2.4% of the population but represented 27.9% of hospital days and 30.2% of adjusted charges. A total of 81.9% of long-stay patients were discharged home. Death occurred in 6.7% of neonatal and 8.4% of pediatric long-stay patients. Mean adjusted charges between age-groups did not differ. Neonatal long-stay patients had an actual LOS and adjusted charges 2 times greater than expected. For pediatric long-stay patients, these variables were 4 times greater than expected. Female sex, black race, age < 30 days, increased severity of illness, complication or infection during hospitalization, and the need for additional care upon discharge increased the likelihood of prolonged LOS. • Conclusions: Long-stay patients in academic children's hospitals are rare but account for a significant proportion of hospital days and charges. Pediatric long-stay patients are responsible for a disproportionate share of increased charges. Improved case management of prolonged hospitalizations may reduce charges and improve quality of care.

Original languageEnglish (US)
Pages (from-to)270-278
Number of pages9
JournalJournal of Clinical Outcomes Management
Volume13
Issue number5
StatePublished - May 1 2006
Externally publishedYes

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Pediatrics
Length of Stay
Hospitalization
Logistic Models
Hospital Charges
Health Information Systems
Quality of Health Care
Case Management
Chi-Square Distribution
Charge
Cohort Studies
Retrospective Studies
Age Groups
Demography
Databases
Length of stay
Infection
Population

ASJC Scopus subject areas

  • Medicine(all)
  • Strategy and Management

Cite this

Maniscalco, J., Ottolini, M., Turenne, W. M., Chavanu, K., & Slonim, A. D. (2006). Long-stay patients in academic children's hospital. Journal of Clinical Outcomes Management, 13(5), 270-278.

Long-stay patients in academic children's hospital. / Maniscalco, Jennifer; Ottolini, Mary; Turenne, Wendy M.; Chavanu, Kathleen; Slonim, Anthony D.

In: Journal of Clinical Outcomes Management, Vol. 13, No. 5, 01.05.2006, p. 270-278.

Research output: Contribution to journalArticle

Maniscalco, J, Ottolini, M, Turenne, WM, Chavanu, K & Slonim, AD 2006, 'Long-stay patients in academic children's hospital', Journal of Clinical Outcomes Management, vol. 13, no. 5, pp. 270-278.
Maniscalco J, Ottolini M, Turenne WM, Chavanu K, Slonim AD. Long-stay patients in academic children's hospital. Journal of Clinical Outcomes Management. 2006 May 1;13(5):270-278.
Maniscalco, Jennifer ; Ottolini, Mary ; Turenne, Wendy M. ; Chavanu, Kathleen ; Slonim, Anthony D. / Long-stay patients in academic children's hospital. In: Journal of Clinical Outcomes Management. 2006 ; Vol. 13, No. 5. pp. 270-278.
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