1110: Picu Hospitalizations Are Associated With Poor Well Child Visit Compliance

Introduction: Time spent in the pediatric intensive care unit (PICU) results in long-term sequelae experienced by survivors and families. Prior studies have looked at factors associated with PICU admissions; however, it remains unknown whether compliance with preventive primary care physician (PCP) visits is associated with risk of PICU admission. We hypothesize that patients admitted to the PICU will be more likely to have completed < 25% of recommended well child checks (WCC) than those either discharged from the ED or admitted to the general floors. Methods: We conducted a retrospective cohort study of patients seen at our hospital from 2011-2024 who were also patients at an associated pediatric PCP office prior to index hospital presentation. Patients were separated into three cohorts by index hospitalization disposition: PICU admission (PICU), admitted to the general floors (HOSP), or discharged from the ED (ED). We report cohort membership, demographics, and PCP WCC compliance in the 2 years prior to index hospitalization binned by percent compliance. We performed a multivariable regression analysis with the outcome of PICU admission, exposure of PCP WCC compliance, and covariates of age, gender, and insurance status. Results: There were 45,930 unique encounters across all three cohorts [PICU: 2.6%, HOSP: 13.9%, ED: 83.5%]. Hospital disposition was significantly associated with PCP WCC compliance (x2: 230, p< 0.001). Patients in the PICU cohort were significantly less likely to have completed >75% of WCC visits prior to admission [PICU: 19.8%, HOSP: 24.6%, ED: 30.5%] and more likely to have completed < 25% of WCC [PICU: 8.8%, HOSP: 5.5%, ED: 5.2%]. In regression analysis, WCC compliance >75% was significantly associated with decreased PICU disposition (OR 0.39, 95% CI: 0.31 – 0.51) when compared to WCC compliance < 25%. Additionally, there’s a dose response relationship between WCC compliance and odds ratio for PICU disposition (26-50%: 0.78, 51-75%: 0.59, >75%: 0.39). Conclusions: In patients seen at our university associated PCP office, we report a significant association between WCC compliance prior to hospital presentation and PICU admission. These associations remain significant when controlled for age, gender, and insurance status. Resources are needed to improve WCC compliance in children.