Children's Hospital Resource Utilization During the 2022 Viral Respiratory Surge

Area of Science:

• Pediatric healthcare epidemiology
• Viral respiratory illness surveillance
• Hospital resource utilization

Background:

• Concurrent viral respiratory epidemics in 2022 presented challenges in understanding their full impact.
• Previous data on the extent of these epidemics and their effect on children's hospitals is limited.
• Accurate assessment is crucial for effective future surge planning in pediatric healthcare settings.

Purpose of the Study:

• To compare the epidemiology and resource utilization of the 2022 viral respiratory season with prepandemic seasons.
• To analyze trends in emergency department (ED), inpatient, and intensive care unit (ICU) volumes.
• To inform future surge planning strategies for pediatric hospitals.

Main Methods:

• A serial cross-sectional study was conducted from October 2017 to March 2023 across 38 US children's hospitals.
• Daily data on ED, inpatient, and ICU volumes, surgeries, and viral tests were collected.
• Proportions of ED revisits and 30-day hospital readmissions were analyzed using hierarchical Poisson models.

Main Results:

• Peak ED, inpatient, and ICU volumes in 2022 were not significantly different from previous peak seasons.
• However, 18 of 38 hospitals recorded their highest ED and inpatient volumes during the 2022 season.
• The 2022 season was longer, saw a 75% increase in viral tests, a 15% decrease in surgeries, and the lowest revisit/readmission rates.

Conclusions:

• While overall peak volumes were comparable, the 2022 viral season placed unprecedented strain on nearly half of children's hospitals.
• The extended duration and high volume suggest a need for revised surge capacity assessments.
• Further research is essential on how these surges affect patient flow, transfer logistics, and outcomes, especially with decreasing pediatric capacity due to regionalization.