Quantifying variation of paediatric patient length of stay among Australasian intensive care units

OBJECTIVE: To quantify variation of mean paediatric patient length of stay (LoS) among intensive care units (ICUs) in Australia and New Zealand METHODS: Retrospective data from Australian and New Zealand institutions with paediatric ICU admissions were analysed. The data were collected between 1997 and 2006 providing a total of 123 institution years of data (an average of 6.15 years per site). Patient LoS was modelled as the outcome variable of a gamma regression with patient risk factors entered as fixed effects (allowing adjustment for case mix) and variation among ICUs modelled using a random effect. RESULTS: Six Australasian ICUs had an average risk-adjusted paediatric LoS which was significantly shorter than average, while five had an average LoS that was significantly longer than average. The remaining nine sites had average LoS that were not significantly different from the average (at the 95% level). Among other risk factors, previous admission to an ICU and respiratory support within the first hour of admission were both associated with prolonged LoS. CONCLUSION: There was significant variation in paediatric patient LoS at the ICU level not accounted for by patient case mix. This has important implications for efficiency of ICU processes and, possibly other parameters of quality of patient care in those institutions with longer LoS.