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Assessing the Relationship between BMI and Resource Utilization

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Assessing the Relationship between BMI and Resource Utilization
Felecia A. Lee, PhD, Ashley M. Hervey, Med, Clint Gates, MD, Brandon Stringer, MD, Gina M. Berg, PhD and Paul Harrison, MD, Wesley Medical Center - University of Kansas School of Medicine, Wichita KS

Objective: Introduction: The purpose of this study was to determine the impact of patient and injury characteristics (specifically BMI) on hospital resource utilization measured as a multifaceted outcome variable in a pediatric trauma population. The hypothesis was that BMI will be associated with hospital resource usage; specifically obese pediatrics would utilize more resources during their hospital stay.
Methods: Retrospective registry study of pediatric patients (aged 2-17 years) admitted to a Midwest Level II pediatric trauma center between 2004 and 2012. Patients were stratified into non-obese (95th percentile), according to published charts for age and gender. Canonical correlation analysis determined the relationship between patient/injury characteristics (age, BMI, ISS, physiological complications) and hospital resource usage (ICU and hospital LOS, medical consults, procedures).
Results: Data analysis included 1620 pediatric patients: 82% (n=1332) non-obese and 18% (n=288) obese. BMI (0.03) was not associated with hospital resource usage. Injury severity (ISS [0.49] and physiologic complications [0.68]) was related to hospital resource usage. The severely injured spent more days in the hospital (0.51) and received more procedures (0.56). Conclusion: This study found that BMI was not associated with resource usage. Injury severity, as assessed in terms of ISS and physiological complications, were associated with hospital resource usage (increase in hospital LOS and procedures). This study provides valuable information concerning the impact of patient/injury characteristics and the utilization of hospital resources in order to provide optimal care to pediatric trauma patients.
Objective: The learner will be able to discuss how patient and injury characteristics (specifically BMI) impacts hospital resource usage in a pediatric trauma population.Objective Content: 1. Trauma is the leading cause of morbidity and mortality for pediatric patients and is resource extensive .Data related to health care utilization for overweight children are limited; one estimate suggests obesity associated inpatient hospitalization costs have risen three-fold from \ million from 1979 through 1981 to \ million from 1997 through 1999. 2. Current health care economics demands optimal patient care at the lowest cost as hospital resources are finite, therefore, appropriate utilization is crucial. 3. The findings of this study suggest that BMI was not associated with resource usage. Injury severity as assessed in terms of Injury Severity Score (ISS) and physiological complications were associated with hospital resource usage (increase in hospital LOS and total procedures).


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