Factors Associated with Length of Stay and Cost among Pediatric Hospitalizations with a Primary Ophthalmic Diagnosis

ABSTRACT

Purpose

To investigate factors associated with prolonged length of stay and high cost among pediatric hospitalizations with a primary ophthalmic diagnosis.

Methods

This retrospective, cross-sectional study utilized data on pediatric admissions with a primary ophthalmic diagnosis from the multicenter 2016 Kids’ Inpatient Database. Multivariable logistic regression models adjusted for demographic, hospital, and admission characteristics were used to evaluate factors associated with prolonged stay and high cost, defined as exceeding the 75^th percentile (>4 days and $12,642, respectively).

Results

An estimated 6,811 pediatric hospitalizations with a primary ophthalmic diagnosis in the United States in 2016 were included. On adjusted analysis, a prolonged length of stay was more likely with Medicaid (vs. private insurance, OR = 1.19, 95% CI: [1.02, 1.40], p = .03), non-trauma (vs. trauma, OR = 2.77, 95% CI: [2.12, 3.63], p < .001) and urban teaching hospitals (vs. rural, OR = 3.48, 95% CI: [1.04, 11.69], p = .04). A high cost of stay was more likely with higher income levels (Quartile 3 vs. 1, OR = 1.30, 95% CI: [1.02, 1.67], p = .04; Quartile 4 vs. 1, OR = 1.49, 95% CI: [1.08, 2.05], p = .02), private insurance (vs. Medicaid, OR = 1.26, 95% CI: [1.04, 1.53], p = .02), Western hospitals (vs. South, OR = 2.74, 95% CI: [1.83, 4.12], p < .001), and trauma (vs. non-trauma, OR = 3.29, 95% CI: [2.57, 4.21], p < .001). Children and young adults had higher odds of prolonged stay, while adolescents and young adults had higher odds of high cost compared to toddlers (p < .05 for all).

Conclusions

Additional work addressing the factors associated with higher resource utilization may help promote the delivery of quality inpatient pediatric eye care.

KEYWORDS:

• Pediatric ophthalmology
• outcomes research
• database
• healthcare cost
• length of stay

Acknowledgments

1. Funding/Support: Hursuong Vongsachang was supported by the National Center for Advancing Translational Sciences, National Institutes of Health under Grant TL1 TR003100.

2. Financial Disclosures: No financial disclosures.

3. Other Acknowledgments: The authors would like to thank the Johns Hopkins Surgery Center for Outcomes Research for their support.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Statement of submission

This submission has not been published anywhere previously and it is not simultaneously being considered for any other publication. It had previously been rejected from The American Journal of Ophthalmology.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/09286586.2022.2124278

Additional information

Funding

Hursuong Vongsachang was supported by the National Center for Advancing Translational Sciences, National Institutes of Health under Grant TL1 TR003100.