We set out to understand some of the factors that alter length of stay(LOS) in the intensive care nursery (ICN). We suspected that the requirement of transport of the neonate during their initial hospitalization may be such a factor, independent of either birthweight or associated diagnosis.

Methods: All infants managed by a disease management system (DM) with a discharge between 7/1/96 and 11/30/97 were included. Infants were assigned to one of 30 groups by birthweight and diagnostic category and LOS was compared with data obtained from the National Perinatal Information Center(NPIC) by corresponding category. LOS was compared to NPIC and the ratio for transported patients relative to inborn patients were compared. The ratio of each patient's LOS and NPIC case mix adjusted estimated LOS were averaged and compared by Student's t-test, between groups of infants that were transported versus inborn.

Results: A population of 2380 infants were evaluated, 2210 who remained at their hospital of birth and 170 who were transported during their neonatal course. The transported infants had hospital stays nearly twice as long as inborn patients (mean ± SD 28 ± 32 transported versus 15± 20 inborns in days). A comparison of case mix adjusted LOS relative to the case mix adjusted NPIC between the two populations revealed that transported infants have a 19% greater LOS to NPIC ratio than that for inborn infants (p=0.0001).

Conclusions: These data demonstrate that outborn infants have an increased LOS when compared to inborn infants that remains significant when controlled for by birthweight and disease process. The requirement for transport appears to be an independent factor in determining neonatal LOS.