PC1070: Why Is NICU Census so High? Declining Birth Rates and Increasing NICU Census During COVID Pandemic

Purpose/Objectives: In United States, birth rate has declined by 20% between 2007 and 2020 and by 3.8% during the span of Covid pandemic per most recent vital statistics reported by CDC. However, Neonatal Intensive care unit (NICU) admission rates seem to have increased during this time with the subjective impression that many NICUs are experiencing unprecedented surges in census or operating at full capacity. At Texas Children’s Hospital, we evaluated our institutional trends in NICU census during Covid Pandemic and examined potential contributing factors.

Objective: to evaluate trends in NICU census over time and associated contributing factors during covid pandemic

Design/Methods: We reviewed data related to NICU admissions, discharges, length of stay, and readmissions that is routinely collected and monitored in the NICU at Texas Children’s Hospital in Houston, Texas. Descriptive analysis was done to understand trends over time between 2019 and current date.

Results: Between 2019 and 2021, the average daily census of the NICU at our institution increased by 12.2% (139 to 156). During this time, number of deliveries per year remained the same, NICU admission rate for inborn infants decreased from 21% to 18.9%, average length of stay increased by 4 days (from 16 to 20), and total number of NICU discharges decreased by 11.2% (2216 to 1916). Review of accommodation codes reflect a trend towards higher patient acuity during this time period. Readmission rates also decreased from 3.87 to 2.57 percent.

Conclusion/Discussion: Based on the trends observed, the total number of deliveries and live births have changed minimally while average length of stay and acuity has increased during the COVID Pandemic at our institution. Further study and evaluation of population level data is needed to better understand the relationship between Covid pandemic on NICU census.