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Published on: February 9, 2011
Factors associated with high resource utilization in pediatric skin and soft tissue infection hospitalizations
Michelle A Lopez1, Andrea T Cruz2, Marc A Kowalkowski3
1Sections of Hospital Medicine, Baylor College of Medicine, Houston, Texas.
Insights
Infants, racial/ethnic minorities, and publicly insured children face longer hospital stays and higher costs for skin and soft tissue infections (SSTIs). These vulnerable groups require targeted interventions to reduce healthcare resource utilization.
Area of Science:
- Pediatric hospital medicine
- Public health
- Health services research
Background:
- Skin and soft tissue infections (SSTIs) are common causes of pediatric hospitalizations.
- Understanding factors contributing to prolonged length of stay (LOS) and increased hospital charges is crucial for optimizing care and resource allocation.
Purpose of the Study:
- To identify patient and hospital-level factors associated with prolonged LOS and increased hospital charges in pediatric hospitalizations for SSTIs.
Main Methods:
- Cross-sectional analysis of pediatric SSTI hospital discharge data from the 2009 Healthcare Cost and Utilization Project Kids' Inpatient Database.
- Multivariate logistic regression was used to assess associations with prolonged LOS and increased charges, controlling for patient and hospital factors.
Main Results:
- Infants, racial/ethnic minorities, and publicly insured children had significantly higher odds of prolonged LOS.
- Adolescents and all racial/ethnic minority groups experienced higher odds of increased hospital charges compared to their respective reference groups.
- The 75th percentile for LOS was 3 days, and for charges was $14,317.
Conclusions:
- Vulnerable pediatric populations, including infants, racial/ethnic minorities, and publicly insured children, demonstrate increased resource utilization for SSTI hospitalizations.
- Findings highlight potential targets for future preventive strategies and public health interventions to mitigate disparities in healthcare outcomes and costs.
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.
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