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Abstract
The aims are to define the demographic profile of the population discharged from paediatric intensive care unit (PICU) between 1 April 2014–31 March 2015; the proportion with chronic diseases; and to identify the clinical and financial burden of chronic disease within this population.
Methods Data on PICU admissions was obtained from the PICANet database. Each admission was manually reviewed using TRAK Care. Inclusion criteria for this study were: admission to PICU within the timeframe; age 0–15 years; total length of stay in hospital greater than 7 days; known or suspected chronic diagnosis; and home address in South-East Scotland (SES).
For eligible patients, the following data was collated: region; sex; primary and secondary diagnoses and teams involved; and total bed days.
Results Of the 169 PICU admissions, 46 patients met our criteria. (Figure 1) The total population under 16 years old in SES is 225,472.2. This cohort accounts for 0.02%.
The total number of days in hospital for this cohort of patients was 2437, with 1403 days in ward-level care, 546 days in high-dependency unit (HDU), and 488 days in PICU. PICANet data showed that the total number of occupied bed days for this period was 1090 for PICU and 2098.45 for HDU. Our cohort accounted for 44.77% and 26.03% respectively.
The average cost per bed day is reported to be £344.67 for ward-level care, £717 for HDU, and £2,085 for PICU. Using these figures, 1403 days in ward-level care costs approximately £483,572.01, 546 days in HDU costs £391,482, and 488 days in PICU costs £1,017,480. Thus it can be determined that over a 1-year period, this small group of patients required inpatient care amounting to a cost of £1,892,534.01. This is an average cost of £41,142.04 per child, per year (Figure 2).
Conclusion To our knowledge, there are no other studies looking at the paediatric population in this context. We have identified a small group of very dependent patients who account for a significant clinical and financial burden. We feel this data will be able to inform service decisions, workforce planning, education for clinician skill sets, and packages of care.