Abstract
We examined the length of stay of 545 patients admitted to the pediatric intensive care unit (PICU), Osaka Medical Center and Research Institute for Maternal and Child Health from January 1, 1997 to December 31, 1999. The mean age of the patients was 2.3 years (range, 0 day-16.8 years). Mean stay in PICU for all patients was 10.6 days (range, 1-203 days), and the total patient days of PICU were 5, 787 days. Patients younger than the age of 28 days (neonates) comprised 19.6% of the PICU patients and occupied 45.1% of the total patient days. Of the neonates, 29 cases (27.1%) were re-admitted to PICU during the same hospitalization. Patients diagnosed with congenital anomalies complicated by severe organ insufficiency, including hypoplastic left heart syndrome, congenital diaphragmatic hernia or omphalocele, needed long PICU stays. Fifty-six percentages of PICU stays of the neonates were not reimbursed by the Japanese health insurance system for the intensive care unit (ICU). Reimbursement for the charges of ICU stay was predetermined to 14 days, however, according to provisional estimates, children and neonates admitted to our PICU required 21 days and 60 days, respectively. We reported the present situation of the PICU in a perinatal center. With the perinatal care progress, neonates will occupy a large fraction of PICU beds. Reform of the health insurance system should be considered to improve pediatric intensive care.
