Unadjusted and Adjusted Estimates of Hospitalization LOS, Receipt of Critical Care Services, and In-Hospital Mortality for CCC TAD Hospitalizations (n = 48 291) and Nontransfer Hospitalizations (n = 477 006)
| Type . | LOS . | Receipt of Critical Care Servicesa . | In-Hospital Mortality . | |||
|---|---|---|---|---|---|---|
| Risk Ratio (95% CI) . | P . | OR (95% CI) . | P . | OR (95% CI) . | P . | |
| Unadjusted | ||||||
| Transfer status | ||||||
| Not transferred | Reference | — | Reference | — | Reference | — |
| TAD | 2.0 (1.8–2.1) | <.001 | 3.7 (3.4–3.9) | <.001 | 4.5 (4.1–4.9) | <.001 |
| Adjusted | ||||||
| Transfer status | — | |||||
| Not transferred | Reference | — | Reference | — | Reference | — |
| TAD | 1.6 (1.5–1.7) | <.001 | 3.0 (2.7–3.2) | <.001 | 3.6 (3.2–3.9) | <.001 |
| No. CCC diagnoses | — | |||||
| Single CCC | Reference | — | Reference | — | Reference | — |
| ≥2 CCCs | 1.3 (1.3–1.4) | <.001 | 1.7 (1.7–1.8) | <.001 | 2.2 (2.0–2.4) | <.001 |
| H-RISKb | 1.0 (1.0–1.0) | <.001 | 1.1 (1.1–1.1) | <.001 | 1.1 (1.1–1.1) | <.001 |
| Age, y | — | |||||
| <1 | Reference | — | Reference | — | Reference | — |
| 1–5 | 0.7 (0.7–0.9) | <.001 | 0.6 (0.6–0.7) | <.001 | 0.8 (0.72–0.90) | <.001 |
| 5–10 | 0.7 (0.7–0.7) | <.001 | 0.4 (0.4–0.5) | <.001 | 0.7 (0.57–0.74) | <.001 |
| 10–15 | 0.8 (0.7–0.8) | <.001 | 0.3 (0.3–0.4) | <.001 | 0.8 (0.66–0.86) | <.001 |
| >15 | 0.8 (0.8–0.8) | <.001 | 0.4 (0.4–0.4) | <.001 | 1.0 (0.9–1.1) | .613 |
| Sex | ||||||
| Male | Reference | — | Reference | — | Reference | — |
| Female | 1.0 (1.0–1.0) | .859 | 0.9 (0.8–0.9) | <.001 | 0.8 (0.7–0.9) | <.001 |
| Median household income based on zip code of patient residence, $ | ||||||
| 1–38 999 | Reference | — | Reference | — | Reference | — |
| 39 000–47 999 | 1.0 (1.0–1.0) | .854 | 1.0 (0.9–1.0) | .133 | 0.9 (0.8–1.0) | .057 |
| 48 000–62 999 | 1.0 (1.0–1.0) | .203 | 0.9 (0.9–1.0) | .023 | 0.8 (0.7–0.9) | .001 |
| 63 000+ | 1.0 (1.0–1.0) | .106 | 0.9 (0.9–1.0) | .051 | 0.8 (0.7–0.9) | .001 |
| Primary expected payer | ||||||
| Private | Reference | — | Reference | — | Reference | — |
| Medicare | 1.0 (1.0–1.1) | .075 | 1.0 (0.8–1.2) | .621 | 0.7 (0.5–1.0) | .038 |
| Medicaid | 1.1 (1.1–1.1) | <.001 | 1.4 (1.3–1.4) | <.001 | 1.0 (0.9–1.1) | .820 |
| Self-pay | 1.0 (0.9–1.0) | .029 | 1.4 (1.3–1.7) | <.001 | 1.8 (1.5–2.3) | <.001 |
| No charge | 1.0 (0.9–1.1) | .705 | 1.4 (0.9–2.1) | .109 | 0.9 (0.4–1.8) | .702 |
| Other | 1.1 (1.0–1.1) | .006 | 1.0 (0.9–1.2) | .687 | 1.1 (0.9–1.3) | .258 |
| Race or ethnicity | ||||||
| White | Reference | — | Reference | — | Reference | — |
| Black | 1.0 (1.0–1.1) | .116 | 0.9 (0.9–1.0) | .034 | 1.1 (1.0–1.2) | .138 |
| Hispanic | 1.0 (1.0–1.2) | .021 | 0.9 (0.9–1.0) | .100 | 1.3 (1.1–1.4) | <.001 |
| Asian or Pacific Islander | 1.1 (1.1–1.2) | <.001 | 1.0 (0.9–1.1) | .706 | 1.6 (1.3–1.8) | <.001 |
| Native American | 1.0 (0.9–1.1) | .635 | 1.0 (0.7–1.3) | .822 | 1.4 (1.0–2.0) | .077 |
| Other | 1.1 (1.0–1.1) | <.001 | 1.0 (0.9–1.1) | .671 | 1.3 (1.1–1.5) | .003 |
| Hospital bed sizec | ||||||
| Large | Reference | — | Reference | — | Reference | — |
| Small | 0.9 (0.8–1.0) | .010 | 0.9 (0.7–1.1) | .204 | 0.9 (0.8–1.2) | .593 |
| Medium | 0.9 (0.8–0.9) | <.001 | 1.0 (0.9–1.1) | .735 | 1.0 (0.8–1.1) | .593 |
| Hospital location and teaching status | ||||||
| Urban teaching | Reference | — | Reference | — | Reference | — |
| Rural | 0.8 (0.7–0.9) | <.001 | 0.7 (0.6–0.8) | <.001 | 0.7 (0.5–1.0) | .019 |
| Urban nonteaching | 0.9 (0.9–1.0) | .051 | 1.0 (0.9–1.1) | .665 | 1.1 (0.9–1.2) | .527 |
| Hospital designationd | ||||||
| Not a children’s hospital | Reference | — | Reference | — | Reference | — |
| Children hospital | 1.2 (1.1–1.3) | <.001 | 1.0 (0.9–1.0) | .239 | 0.8 (0.7–0.9) | <.001 |
| Type . | LOS . | Receipt of Critical Care Servicesa . | In-Hospital Mortality . | |||
|---|---|---|---|---|---|---|
| Risk Ratio (95% CI) . | P . | OR (95% CI) . | P . | OR (95% CI) . | P . | |
| Unadjusted | ||||||
| Transfer status | ||||||
| Not transferred | Reference | — | Reference | — | Reference | — |
| TAD | 2.0 (1.8–2.1) | <.001 | 3.7 (3.4–3.9) | <.001 | 4.5 (4.1–4.9) | <.001 |
| Adjusted | ||||||
| Transfer status | — | |||||
| Not transferred | Reference | — | Reference | — | Reference | — |
| TAD | 1.6 (1.5–1.7) | <.001 | 3.0 (2.7–3.2) | <.001 | 3.6 (3.2–3.9) | <.001 |
| No. CCC diagnoses | — | |||||
| Single CCC | Reference | — | Reference | — | Reference | — |
| ≥2 CCCs | 1.3 (1.3–1.4) | <.001 | 1.7 (1.7–1.8) | <.001 | 2.2 (2.0–2.4) | <.001 |
| H-RISKb | 1.0 (1.0–1.0) | <.001 | 1.1 (1.1–1.1) | <.001 | 1.1 (1.1–1.1) | <.001 |
| Age, y | — | |||||
| <1 | Reference | — | Reference | — | Reference | — |
| 1–5 | 0.7 (0.7–0.9) | <.001 | 0.6 (0.6–0.7) | <.001 | 0.8 (0.72–0.90) | <.001 |
| 5–10 | 0.7 (0.7–0.7) | <.001 | 0.4 (0.4–0.5) | <.001 | 0.7 (0.57–0.74) | <.001 |
| 10–15 | 0.8 (0.7–0.8) | <.001 | 0.3 (0.3–0.4) | <.001 | 0.8 (0.66–0.86) | <.001 |
| >15 | 0.8 (0.8–0.8) | <.001 | 0.4 (0.4–0.4) | <.001 | 1.0 (0.9–1.1) | .613 |
| Sex | ||||||
| Male | Reference | — | Reference | — | Reference | — |
| Female | 1.0 (1.0–1.0) | .859 | 0.9 (0.8–0.9) | <.001 | 0.8 (0.7–0.9) | <.001 |
| Median household income based on zip code of patient residence, $ | ||||||
| 1–38 999 | Reference | — | Reference | — | Reference | — |
| 39 000–47 999 | 1.0 (1.0–1.0) | .854 | 1.0 (0.9–1.0) | .133 | 0.9 (0.8–1.0) | .057 |
| 48 000–62 999 | 1.0 (1.0–1.0) | .203 | 0.9 (0.9–1.0) | .023 | 0.8 (0.7–0.9) | .001 |
| 63 000+ | 1.0 (1.0–1.0) | .106 | 0.9 (0.9–1.0) | .051 | 0.8 (0.7–0.9) | .001 |
| Primary expected payer | ||||||
| Private | Reference | — | Reference | — | Reference | — |
| Medicare | 1.0 (1.0–1.1) | .075 | 1.0 (0.8–1.2) | .621 | 0.7 (0.5–1.0) | .038 |
| Medicaid | 1.1 (1.1–1.1) | <.001 | 1.4 (1.3–1.4) | <.001 | 1.0 (0.9–1.1) | .820 |
| Self-pay | 1.0 (0.9–1.0) | .029 | 1.4 (1.3–1.7) | <.001 | 1.8 (1.5–2.3) | <.001 |
| No charge | 1.0 (0.9–1.1) | .705 | 1.4 (0.9–2.1) | .109 | 0.9 (0.4–1.8) | .702 |
| Other | 1.1 (1.0–1.1) | .006 | 1.0 (0.9–1.2) | .687 | 1.1 (0.9–1.3) | .258 |
| Race or ethnicity | ||||||
| White | Reference | — | Reference | — | Reference | — |
| Black | 1.0 (1.0–1.1) | .116 | 0.9 (0.9–1.0) | .034 | 1.1 (1.0–1.2) | .138 |
| Hispanic | 1.0 (1.0–1.2) | .021 | 0.9 (0.9–1.0) | .100 | 1.3 (1.1–1.4) | <.001 |
| Asian or Pacific Islander | 1.1 (1.1–1.2) | <.001 | 1.0 (0.9–1.1) | .706 | 1.6 (1.3–1.8) | <.001 |
| Native American | 1.0 (0.9–1.1) | .635 | 1.0 (0.7–1.3) | .822 | 1.4 (1.0–2.0) | .077 |
| Other | 1.1 (1.0–1.1) | <.001 | 1.0 (0.9–1.1) | .671 | 1.3 (1.1–1.5) | .003 |
| Hospital bed sizec | ||||||
| Large | Reference | — | Reference | — | Reference | — |
| Small | 0.9 (0.8–1.0) | .010 | 0.9 (0.7–1.1) | .204 | 0.9 (0.8–1.2) | .593 |
| Medium | 0.9 (0.8–0.9) | <.001 | 1.0 (0.9–1.1) | .735 | 1.0 (0.8–1.1) | .593 |
| Hospital location and teaching status | ||||||
| Urban teaching | Reference | — | Reference | — | Reference | — |
| Rural | 0.8 (0.7–0.9) | <.001 | 0.7 (0.6–0.8) | <.001 | 0.7 (0.5–1.0) | .019 |
| Urban nonteaching | 0.9 (0.9–1.0) | .051 | 1.0 (0.9–1.1) | .665 | 1.1 (0.9–1.2) | .527 |
| Hospital designationd | ||||||
| Not a children’s hospital | Reference | — | Reference | — | Reference | — |
| Children hospital | 1.2 (1.1–1.3) | <.001 | 1.0 (0.9–1.0) | .239 | 0.8 (0.7–0.9) | <.001 |
—, not applicable.
Based on ICD-9 diagnosis and procedure codes consistent with ICU admission.
The H-RISK was introduced by Richardson et al.20
The bed size definition varies according to region on the basis of the American Hospital Association survey of hospitals.
Based on information provided by the Children’s Hospital Association.