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Patient characteristics and resource utilisation in paediatric intensive care
R J Gemke1, G J Bonsel, J McDonnell
1Department of Paediatric Intensive Care, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
Archives of Disease in Childhood
|October 1, 1994
Summary
Basic clinical factors significantly predict resource use in pediatric intensive care. Higher total and daily resource utilization (TISS) were observed in non-survivors, highlighting the need for tailored care strategies.
Area of Science:
- Pediatric Intensive Care Medicine
- Health Services Research
Background:
- Resource utilization in pediatric intensive care units (PICUs) is a critical concern.
- Understanding factors influencing resource consumption is essential for efficient healthcare management.
Purpose of the Study:
- To investigate the relationship between basic clinical characteristics and resource utilization in pediatric intensive care.
- To identify key determinants of resource consumption in PICU admissions.
Main Methods:
- An open prospective study involving 593 pediatric intensive care admissions.
- Resource utilization measured using the Therapeutic Intervention Score System (TISS), including total (TISSTOT) and average daily (TISSMEAN) scores, and length of stay (LOS).
- Multiple regression analysis to identify predictive determinants of resource utilization.
Main Results:
- Non-survivors (8.4% of admissions) accounted for 14.1% of total resource utilization.
- Non-survivors had higher TISSTOT and TISSMEAN, but similar LOS compared to survivors.
- Severity of illness, surgical status, chronic comorbidity, emergency admission, and transfer status were significant predictors of TISSTOT (r²=0.19) and TISSMEAN (r²=0.45).
Conclusions:
- TISSTOT and TISSMEAN are suitable non-monetary measures for assessing resource utilization in pediatric intensive care.
- A limited set of clinical characteristics effectively predicts a substantial portion of resource utilization.
- Resource utilization appears warranted in high-risk patients, with evidence of prolonged intensive treatment effectiveness.