Estimating Length of Stay by Patient Type in the Neonatal Intensive Care Unit

Henry C. Lee; Mihoko V. Bennett; Joseph Schulman; Jeffrey B. Gould; Jochen Profit

doi:10.1055/s-0036-1572433

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2016; 33(08): 751-757
DOI: 10.1055/s-0036-1572433

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Estimating Length of Stay by Patient Type in the Neonatal Intensive Care Unit

Authors

Henry C. Lee

¹Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, California

²California Perinatal Quality Care Collaborative, Palo Alto, California
Mihoko V. Bennett

¹Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, California

²California Perinatal Quality Care Collaborative, Palo Alto, California
Joseph Schulman

³California Department of Health Care Services, Sacramento, California
Jeffrey B. Gould

¹Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, California

²California Perinatal Quality Care Collaborative, Palo Alto, California
Jochen Profit

¹Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, California

²California Perinatal Quality Care Collaborative, Palo Alto, California

Abstract

Objective Develop length of stay prediction models for neonatal intensive care unit patients.

Study Design We used data from 2008 to 2010 to construct length of stay models for neonates admitted within 1 day of age to neonatal intensive care units and surviving to discharge home.

Results Our sample included 23,551 patients. Median length of stay was 79 days when birth weight was < 1,000 g, 46 days for 1,000 to 1,500 g, 21 days for 1,500 to 2,500 g, and 8 days for ≥2,500 g. Risk factors for longer length of stay varied by weight. Units with shorter length of stay for one weight group had shorter lengths of stay for other groups.

Conclusion Risk models for comparative assessments of length of stay need to appropriately account for weight, particularly considering the cutoff of 1,500 g. Refining prediction may benefit counseling of families and health care systems to efficiently allocate resources.

Keywords

length of stay - neonatal intensive care unit - very low birth weight - extremely low birth weight

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Referenzen

References
1 Turner M, Winefield H, Chur-Hansen A. The emotional experiences and supports for parents with babies in a neonatal nursery. Adv Neonatal Care 2013; 13 (6) 438-446
2 Profit J, McCormick MC, Escobar GJ , et al. Neonatal intensive care unit census influences discharge of moderately preterm infants. Pediatrics 2007; 119 (2) 314-319
3 Littig SJ, Isken MW. Short term hospital occupancy prediction. Health Care Manage Sci 2007; 10 (1) 47-66
4 Iwashyna TJ, Kramer AA, Kahn JM. Intensive care unit occupancy and patient outcomes. Crit Care Med 2009; 37 (5) 1545-1557
5 Lee HC, Bennett MV, Schulman J, Gould JB. Accounting for variation in length of NICU stay for extremely low birth weight infants. J Perinatol 2013; 33 (11) 872-876
6 Hintz SR, Bann CM, Ambalavanan N, Cotten CM, Das A, Higgins RD ; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Predicting time to hospital discharge for extremely preterm infants. Pediatrics 2010; 125 (1) e146-e154
7 Ortenstrand A, Westrup B, Broström EB , et al. The Stockholm Neonatal Family Centered Care Study: effects on length of stay and infant morbidity. Pediatrics 2010; 125 (2) e278-e285
8 Caine J. The effects of music on the selected stress behaviors, weight, caloric and formula intake, and length of hospital stay of premature and low birth weight neonates in a newborn intensive care unit. J Music Ther 1991; 28 (4) 180-192
9 Maia C, Brandão R, Roncalli A, Maranhão H. Length of stay in a neonatal intensive care unit and its association with low rates of exclusive breastfeeding in very low birth weight infants. J Matern Fetal Neonatal Med 2011; 24 (6) 774-777
10 Melnyk BM, Feinstein NF, Alpert-Gillis L , et al. Reducing premature infants' length of stay and improving parents' mental health outcomes with the Creating Opportunities for Parent Empowerment (COPE) neonatal intensive care unit program: a randomized, controlled trial. Pediatrics 2006; 118 (5) e1414-e1427
11 Profit J, Zupancic JA, Gould JB , et al. Correlation of neonatal intensive care unit performance across multiple measures of quality of care. JAMA Pediatr 2013; 167 (1) 47-54
12 Richardson DK, Corcoran JD, Escobar GJ, Lee SK. SNAP-II and SNAPPE-II: simplified newborn illness severity and mortality risk scores. J Pediatr 2001; 138 (1) 92-100
13 Zupancic JA, Richardson DK, Horbar JD, Carpenter JH, Lee SK, Escobar GJ ; Vermont Oxford Network SNAP Pilot Project Participants. Revalidation of the Score for Neonatal Acute Physiology in the Vermont Oxford Network. Pediatrics 2007; 119 (1) e156-e163
14 Altman M, Vanpée M, Cnattingius S, Norman M. Moderately preterm infants and determinants of length of hospital stay. Arch Dis Child Fetal Neonatal Ed 2009; 94 (6) F414-F418
15 Bannwart DdeC, Rebello CM, Sadeck LS, Pontes MD, Ramos JL, Leone CR. Prediction of length of hospital stay in neonatal units for very low birth weight infants. J Perinatol 1999; 19 (2) 92-96
16 Berry MA, Shah PS, Brouillette RT, Hellmann J. Predictors of mortality and length of stay for neonates admitted to children's hospital neonatal intensive care units. J Perinatol 2008; 28 (4) 297-302
17 Manktelow B, Draper ES, Field C, Field D. Estimates of length of neonatal stay for very premature babies in the UK. Arch Dis Child Fetal Neonatal Ed 2010; 95 (4) F288-F292
18 Bender GJ, Koestler D, Ombao H , et al. Neonatal intensive care unit: predictive models for length of stay. J Perinatol 2013; 33 (2) 147-153