Demonstrating the relationships of length of stay, cost and clinical outcomes in a simulated NICU.

Journal Article (Journal Article)

OBJECTIVE: Health-care leaders place significant focus on reducing the average length of stay (ALOS). We examined the relationships among ALOS, cost and clinical outcomes using a neonatal intensive care unit (NICU) simulation model. STUDY DESIGN: A discrete-event NICU simulation model based on the Duke NICU was created. To identify the relationships among ALOS, cost and clinical outcomes, we replaced the standard probability distributions with composite distributions representing the best and worst outcomes published by the National Institutes of Health Neonatal Research Network. RESULT: Both average cost per patient and average cost per ⩽28 week patient were lower in the best NICU ($16,400 vs $19,700 and $56,800 vs $76,700, respectively), while LOS remained higher (27 vs 24 days). CONCLUSION: Our model demonstrates that reducing LOS does not uniformly reduce hospital resource utilization. These results suggest that health-care leaders should not simply rely on initiatives to reduce LOS without clear line-of-sight on clinical outcomes as well.

Full Text

Duke Authors

Cited Authors

  • DeRienzo, C; Kohler, JA; Lada, E; Meanor, P; Tanaka, D

Published Date

  • December 2016

Published In

Volume / Issue

  • 36 / 12

Start / End Page

  • 1128 - 1131

PubMed ID

  • 27583389

Electronic International Standard Serial Number (EISSN)

  • 1476-5543

Digital Object Identifier (DOI)

  • 10.1038/jp.2016.128


  • eng

Conference Location

  • United States