Epidemiology of Pediatric Critical Care Admissions in 43 United States Children's Hospitals, 2014-2019∗

Julia A. Heneghan, Colin Rogerson, Denise M. Goodman, Matt Hall, Joseph G. Kohne, Jason M. Kane

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


OBJECTIVES: To identify trends in the population of patients in PICUs over time.

DESIGN: Cross-sectional, retrospective cohort study using the Pediatric Health Information System database.

SETTING: Forty-three U.S. children's hospitals.

PATIENTS: All patients admitted to Pediatric Health Information System-participating hospitals from January 2014 to December 2019. Individuals greater than 65 years old and normal newborns were excluded.


MEASUREMENTS AND MAIN RESULTS: PICU care occurred in 13.8% of all pediatric hospital encounters and increased over the study period from 13.3% to 14.3%. Resource intensity, based on average Hospitalization Resource Intensity Scores for Kids score, increased significantly across epochs (6.5 in 2014-2015 vs 6.9 in 2018-2019; p < 0.001), although this was not consistently manifested as additional procedural exposure. Geometric mean PICU cost per patient encounter was stable. The two most common disease categories in PICU patients were respiratory failure and cardiac and circulatory congenital anomalies. Of all PICU encounters, 35.5% involved mechanical ventilation, and 25.9% involved vasoactive infusions. Hospital-level variation in the percentage of days spent in the PICU ranged from 15.1% to 63.5% across the participating sites. Of the total hospital costs for patients admitted to the PICU, 41.7% of costs were accrued during the patients' PICU stay.

CONCLUSIONS: The proportional use of PICU beds is increasing over time, although was variable across centers. Case-based resource use and complexity of pediatric patients are also increasing. Despite the higher use of PICU resources, the standardized costs of PICU care per patient encounter have remained stable. These data may help to inform current PICU resource allocation and future PICU capacity planning.

Original languageEnglish (US)
Pages (from-to)484-492
Number of pages9
JournalPediatric Critical Care Medicine
Issue number7
StatePublished - Jul 1 2022

Bibliographical note

Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.


  • epidemiology
  • hospital costs; ICUs
  • pediatric
  • resource allocation
  • Cross-Sectional Studies
  • Humans
  • Hospitals, Pediatric
  • Infant
  • Intensive Care Units, Pediatric
  • Hospitalization
  • United States/epidemiology
  • Critical Care
  • Aged
  • Retrospective Studies
  • Child
  • Infant, Newborn

PubMed: MeSH publication types

  • Journal Article


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