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Factors Associated with Hospital Length of Stay and Intensive Care Utilization Among Pediatric COVID-19 Patients in Southern Nevada: A Multivariate Analysis

Year: 2025
Type: article
Study design: Observational Study
Abstract: The COVID-19 pandemic has revealed significant disparities in health outcomes across various populations, with children being no exception. Objective: This study aimed to identify factors associated with hospital length of stay and intensive care unit (ICU) utilization among children hospitalized with COVID-19. Methods: The project evaluated inpatient COVID-19 hospitalization data of children aged 0 to 17 years between 2020 and 2021 with a positive PCR COVID-19 test 14 days prior to or during hospitalization. Using a multivariate linear regression model, hospital length of stay and ICU utilization were evaluated by sociodemographic factors, including age, gender, race/ethnicity, primary payer status, comorbidities, CDC Social Vulnerability Index (SVI), and clinical factors. Results: Among 376 hospitalized pediatric patients, 62.2% were non-White minorities, 4.3% had at least one comorbidity, and 58.5% were covered by public insurance. Additionally, 67.6% scored high on the SVI. The average hospital stay was 3.89 days (standard deviation (SD) = 4.8), and 25% of children utilized the ICU during their hospitalization (SD = 0.43). After adjusting for sociodemographic and clinical characteristics, minority patients were more likely to have a longer length of stay by 1.09 days compared to White patients. Minority patients were also 72% more likely to use the ICU than White patients. Conclusions: These findings demonstrate that non-White children experience more severe outcomes related to COVID-19, supporting the need for culturally specific mitigation and intervention strategies for children and families during a pandemic.
Source: Children
DOI: 10.3390/children12030332
Authors: Erika Marquez, Amanda Haboush-Deloye, Jihye Kim, Erick B López, Anil T. Mangla, Binita Adhikari, Jay J. Shen
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $2,896
Award: SNHD COVID-19 HEALTH DISPARITIES - AS A PUBLIC HEALTH ENTITY DEDICATED TO ELIMINATING DISPARITIES AND ADVANCING EQUITY IN OUR COMMUNITY, THE SOUTHERN NEVADA HEALTH DISTRICT (SNHD) IS WELL SUITED TO CARRY OUT AND COORDINATE STRATEGIES TO ADVANCE HEALTH EQUITY AND ADDRESS COVID-19-RELATED HEALTH DISPARITIES FOR POPULATIONS AT HIGHER RISK AND THAT ARE UNDERSERVED, INCLUDING RACIAL AND ETHNIC MINORITY GROUPS AND PEOPLE LIVING IN RURAL COMMUNITIES THROUGH THIS GRANT PROJECT.SNHD'S COVID-19 HEALTH DISPARITIES PROJECT WILL MOBILIZE A ROBUST NETWORK OF COMMUNITY PARTNER TO IMPLEMENT ACTIVITIES ACROSS THE FOUR OVERARCHING STRATEGIES FOR THE PROJECT. ACTIVITIES INCLUDE:STRATEGY 11. EXPAND TESTING AND CONTACT TRACING.2. PARTNER COLLABORATION - IDENTIFY AND ESTABLISH COLLABORATIONS WITH CRITICAL PARTNERS AFFILIATED WITH POPULATIONS AT HIGHER RISK AND THAT ARE UNDERSERVED, INCLUDING RACIAL AND ETHNIC MINORITY GROUPS AT HIGHER RISK FOR COVID-193. WASTE WATER TESTING4. COVID-19/DISEASE EDUCATIONAL CLINICS FOR URBAN UNDERSERVED, RURAL HEALTH AND PUBLIC HEALTH PROFESSIONALS5. CONVERSATIONAL AI BOTSTRATEGY 21. IMPROVE DATA QUALITY OF RACE / ETHNICITY AND OTHER DEMOGRAPHIC INFORMATION COLLECTION AND EDUCATE PROVIDERS ON THE IMPORTANCE OF THE RACE / ETHNICITY DATA AND APPROPRIATE STRATEGIES TO COLLECT IT BY WORKING WITH HEALTHIER NEVADA.2. PROVIDE GEOCODING SERVICE FOR ALL COVID-19 DATA, SPATIAL ANALYSIS OF DISPARITIES IN COVID-19, AND VACCINE PHASES AND WAVES AND GIS TRAINING TO SNHD EMPLOYEES.3. ENHANCE ECR REPORTING AND IMPLEMENTATION FROM LOCAL HEALTH CARE PROVIDERS.4. IMPLEMENT AN APPLICATION TO AUTOMATE FAX OPTICAL CHARACTER RECOGNITION AND AUTOMATED INSERTION FOR COVID-19 DISEASE TRACKING, CASE INVESTIGATION, AND CONTACT TRACING.5. IMPROVE DATA COLLECTION AND REPORTING FOR TESTING AND CONTACT TRACING FOR POPULATIONS AT HIGHER RISK AND THAT ARE UNDERSERVED. 6. BUILD ON PLANS FOR COLLECTING AND REPORTING TIMELY, COMPLETE, REPRESENTATIVE, AND RELEVANT DATA ON TESTING, INCIDENCE, VACCINAT ION, AND SEVERE OUTCOMES BY DETAILED RACE AND ETHNICITY CATEGORIES, TAKING INTO ACCOUNT AGE AND SEX DIFFERENCES BETWEEN GROUPS.7. DEVELOP KEY PRINCIPLES AND RESOURCES FOR COLLECTING, ANALYZING, REPORTING, AND DISSEMINATING HEALTH EQUITY-RELATED DATA TO INFORM ACTION DURING A PUBLIC HEALTH EMERGENCY.8. ASSURE ADEQUATE RESOURCES FOR DATA INFRASTRUCTURE AND WORKFORCE TO ENSURE ALIGNMENT WITH DATA MODERNIZATION.9. PROVIDE THE BASELINE DATA FOR ESTABLISHING HEALTHCARE EQUITY MODELS.10. USE COMMUNITY SURVEYS AND FOCUS GROUPS TO ADVISE THE DEVELOPMENT OF SOCIAL MEDIA AND OTHER MEDIA STRATEGIES TO ENSURE EFFECTIVE, CULTURALLY SENSITIVE AND CULTURALLY COMPETENT MESSAGING REGARDING COVID-19.STRATEGY 31. ESTABLISH HEALTH EQUITY POSITIONS TO GUIDE ADDRESSING COVID-19 AMONG COMMUNITIES AT HIGHER RISK AND THAT ARE UNDERSERVED.2. UPDATE JURISDICTIONS' COVID-19 PLANS AND HEALTH EQUITY PLANS TO SUPPORT COMMUNITIES MOST AT RISK FOR COVID-19, WITH THE INTENTION OF SETTING UP SYSTEMS THAT PUT IN PLACE INFRASTRUCTURES AND PLANS THAT CAN ALSO SUPPORT FUTURE EMERGENCY RESPONSES.3. BUILD AND EXPAND THE FAITH-BASED COMMUNITY'S CAPACITY TO INFLUENCE, ASSESS, AND ADDRESS THE NEEDS OF COMMUNITIES DISPROPORTIONATELY AFFECTED BY COVID-19.4. EXPAND PUBLIC HEALTH WORKFORCE, INCLUDING HIRING PEOPLE FROM THE COMMUNITY WHO ARE EQUIPPED TO ASSESS AND ADDRESS THE NEEDS OF COMMUNITIES DISPROPORTIONATELY AFFECTED BY COVID-19.5. ESTABLISH ADDITIONAL COMMUNITY CLINICS IN UNDERSERVED AREAS.STRATEGY 41. DEVELOP CULTURALLY APPROPRIATE EDUCATIONAL AND INFORMATIONAL CAMPAIGNS AND OUTREACH PROGRAMS TO INCREASE VACCINE RATES AMONG DISPROPORTIONATELY IMPACTED POPULATIONS. 2. ESTABLISH A SOUTHERN NEVADA RURAL MEDICAL EDUCATION COLLABORATIVE
OpenAlex ID: W4408197154
FWCI: 0.732
Cites: 25
Cited by: 1
Related to: 10