EFFICIENCY OF PEDIATRIC INTENSIVE CARE: A COMPARATIVE ANALYSIS OF 8 PEDIATRIC ICUS

A national standard of ICU efficiency does not exist. This study objectively measures efficiency rates in 8 PICUs to determine if PICUs greatly differ in their efficiencies. Data included demographics, daily mortality risk (Dynamic Risk Index) and therapeutic interventions. Inefficient use of PICU resources was defined using daily mortality risks and a previously developed list of unique PICU resources; (a) low risk, monitored (LRM) pts had daily mortality risks of 1% during the early ICU stay but their last, consecutive PICU day were equivalent to LRM pts. Total, LRM and PED days of care were used to calculate efficiency rates. RESULTS. Data was collected on 1668 pts and 6962 days of care. LRM pts comprised from 16% to 58% of the PICU pts (p <.0001) and utilized between 5.4% and 34.5% of the days of care (p< .0001). PED pts comprised from 12% to 29% of the PICU pts (p < .0001) and their PED days comprised from 5.1% to 17.2%. Overall, the efficiency ratings ranged from .89 to .55. CONCLUSIONS. (1) Large differences in efficiency of PICU utilization exist. (2) The finding of significant over-utilization by PED patients is unique. (3) Efficiency rates over .80 are reasonable. Supported by MCH grant MCJ-11-527.