Objective:

To describe inpatient length of stay patterns, identify key drivers related to prolonged length of stay, and evaluate the relationship between length of stay and readmission in pediatric neurology

Methods:

This was a retrospective review of patients <19 years old admitted with a principal neurologic diagnosis to our hospital between January 2017 and July 2019. Scheduled admissions and hospital admissions lasting >30 days were excluded from analysis. Length of stay was obtained in addition to demographic characteristics, principal discharge diagnosis, multispecialty care, use of multiple antiseizure medications, inpatient hospital costs (ie, claims paid), and pediatric intensive care unit (ICU) admission for unplanned admissions and 7- and 30-day readmissions.

Results:

There were a total of 1579 unplanned admissions. The most common reasons for admission were seizure (n = 942), headache (n = 161), other neurologic diagnosis (n = 121), and psychiatric disorders/functional neurologic disorder (n = 60). Children admitted to the hospital for a neurologic condition have an average length of stay of 2.8±5.0 days for unplanned admissions, 4.5±7.4 days for 7-day readmissions, and 5.2±7.5 days for 30-day readmissions. Average inpatient hospital costs were $44 075±56 976 for unplanned admissions, $60 361±71 427 for 7-day readmissions, and $55 434±56 442 for 30-day readmissions. Prolonged length of stay and increased hospital costs were associated with pediatric ICU admission, multispecialty care, 7- and 30-day readmission, multiple antiseizure medications, and psychiatric disorders / functional neurologic disorders.

Conclusions:

Pediatric ICU admission, multispecialty care, readmission, multiple antiseizure medications, and psychiatric disorder / functional neurologic disorder prolong length of stay and increase hospital costs.

中文翻译：

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儿科神经内科住院时间

客观的：

描述住院时间模式，确定与延长住院时间相关的关键驱动因素，并评估住院时间与儿科神经病学再入院之间的关系

方法：

这是对 2017 年 1 月至 2019 年 7 月期间因主要神经系统诊断入院的年龄小于 19 岁的患者的回顾性研究。计划入院和住院时间超过 30 天的患者被排除在分析之外。除了人口统计学特征、主要出院诊断、多专科护理、多种抗癫痫药物的使用、住院费用（即支付的索赔）以及因计划外入院和 7 岁及30 天再入院。

结果：

共有 1579 人计划外招生。入院的最常见原因是癫痫发作 (n = 942)、头痛 (n = 161)、其他神经系统诊断 (n = 121) 和精神疾病/功能性神经系统疾病 (n = 60)。因神经系统疾病入院的儿童的平均住院时间为非计划入院 2.8±5.0 天，再入院 7 天为 4.5±7.4 天，再入院 30 天为 5.2±7.5 天。非计划入院的平均住院费用为 44 075±56 976 美元，7 天再入院的平均住院费用为 60 361±71 427 美元，30 天再入院的平均住院费用为 55 434±56 442 美元。住院时间延长和住院费用增加与儿科 ICU 入院、多专科护理、7 天和 30 天再入院、多种抗癫痫药物和精神疾病/功能性神经系统疾病有关。

结论：

儿科 ICU 入院、多专科护理、再入院、多种抗癫痫药物和精神疾病/功能性神经系统疾病会延长住院时间并增加住院费用。