Nursing intensity scores did not correlate well with reimbursement claims for infant bronchiolitis

Abstract

Aim We retrospectively evaluated the hospital reimbursement rates for inpatient bronchiolitis treatment and then compared them to the RAFAELA® nursing intensity scores. Methods We selected all 44 bronchiolitis patients treated in the paediatric intensive care unit (PICU) and then for each PICU‐treated patient two patients treated on the ward (n = 88) under 12 months of age in 2010‐2015. The data included medical histories, hospital reimbursement rates using the Nordic Diagnosis Related Groups (NordDRG) or expense categories and the RAFAELA® scores. Results Reimbursement claims were mostly based on expense categories for PICU admissions and NordDRG categories for ward admissions. The median (range) was €6352 (€1330‐30 554) and €2009 (€768‐6027) per episode for the PICU and ward cases, respectively. The median lengths of hospital stay were 8.5 days (3‐18) and 3 days (1‐8), respectively. Higher RAFAELA® scores were associated with nasal continuous positive airway pressure therapy and mechanical ventilation in the PICU and oxygen supplementation and nasogastric tube feeding on the ward. The correlation coefficients between RAFAELA® scores and hospital reimbursement claims ranged from 0.121‐0.450. Conclusion Hospital reimbursement claim for a PICU admission was three times as much as a ward admission and reimbursement claims for bronchiolitis did not match with nursing intensity scores.