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The impact of transfers from neonatal intensive care to paediatric intensive care

Emma E Williams1, Rebecca Lee1, Nia Williams2

  • 1Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.

Journal of Perinatal Medicine
|February 5, 2021
PubMed

Insights

Infants transferred from neonatal intensive care units (NICUs) to paediatric intensive care units (PICUs) represent a small patient group but require significant resources. Premature infants (<28 weeks gestation) incur longer stays, impacting PICU bed capacity planning.

Area of Science:

  • Neonatal and Pediatric Intensive Care
  • Healthcare Resource Utilization
  • Infant Health Outcomes

Background:

  • Neonatal intensive care unit (NICU) graduates may require ongoing care in a paediatric intensive care unit (PICU).
  • Concerns exist regarding the resource demands of these NICU-to-PICU transfers, lacking robust evidence.
  • This study quantifies the impact of NICU transfers on PICU resource utilization.

Purpose of the Study:

  • To determine the impact of infants transferred from NICUs to PICUs on PICU resources.
  • To analyze the length of stay and associated costs for NICU transfers.
  • To identify specific patient subgroups within NICU transfers that may disproportionately affect PICU resources.

Main Methods:

  • A retrospective review of 10 years of NICU admissions to two tertiary PICUs was conducted.
  • Data from approximately 12,000 PICU admissions were analyzed.
  • Patient demographics, gestational age, length of stay, and costs were examined.

Main Results:

  • Sixty-seven infants were transferred from NICUs, constituting a small fraction of total PICU admissions.
  • The median length of stay was 12 days, with infants born <28 weeks gestation experiencing significantly longer stays (32 days) compared to more mature infants (7.5 days).
  • The median cost per NICU transfer patient was £23,800, with total care costs amounting to £6,457,955.

Conclusions:

  • NICU transfers represent a minor proportion of PICU admissions but have a substantial impact on resource utilization.
  • Infants born prematurely (<28 weeks gestation) require prolonged PICU stays, necessitating consideration in bed capacity planning.
  • The findings highlight the need for strategic resource allocation within PICUs to accommodate the specific needs of NICU-transferred infants.
Abstract

Keywords:
chronic lung diseasecost of careneonatal intensive carepaediatric intensive careprematurity

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