Critical Care |

Nonmedical Out-of-Pocket Expenses, Work Absenteeism, and Productivity for Families With a Child Admitted to the Pediatric Intensive Care Unit FREE TO VIEW

Maureen Clark, MS; Brian Cummings, MD; Karen Kuhlthau, PhD; Natalie Frassica; Natan Noviski, MD
Author and Funding Information

Massachusetts General Hospital, Boston, MA

Chest. 2015;148(4_MeetingAbstracts):223A. doi:10.1378/chest.2220469
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SESSION TITLE: Critical Care Poster Discussion

SESSION TYPE: Original Investigation Poster Discussion

PRESENTED ON: Sunday, October 25, 2015 at 01:30 PM - 03:00 PM

PURPOSE: To examine the nonmedical out-of-pocket expenses (NMOOPEs), work absenteeism and productivity for parents with a child admitted to the Pediatric Intensive Care Unit (PICU) with a new acute diagnosis.

METHODS: Prospective, single center study of parents of children admitted to the PICU for 2 or more days. Verbal questionnaire regarding NMOOPEs was administered daily until PICU discharge and reviewed travel, parking, meals, accommodations, communication, caring for siblings, incidental expenses, and homemaking expenses. Parents were stratified into 3 groups based on annual income (<$50,999, <$51,000-99,000, >$100,000) and an estimated daily budget (DB) was calculated. Financial impact was calculated by daily NMOOPE divided by their DB to determine % NMOOPEs of DB. A modified caregiver version of the Work Productivity and Activity Impairment Scale (WPAI) was administered every other day to assess the parent’s work presenteeism, absenteeism, productivity, hours missed, and ability to engage in normal daily activities.

RESULTS: Thirty-eight families with a median PICU length of stay of 3 days (range 2-16) were surveyed. The mean NMOOPEs for all families enrolled was $127 +/- 107, with variability in expenditures among families regardless of length of stay (LOS) in the PICU or income level reported, expenses ranged from ($0-511). The median % NMOOPE of DB in the three income brackets were 36% (range 0-136%), 10% (5-18%) and 16% (4-39%), respectively. Work absenteeism across all families was 78 days, with high levels of distraction noted in those did work due to financial stressors. All families reported inability to attend to normal daily activities during admission. Strategies performed by parents to reduce NMOOPEs including skipping meals, choosing to incur parking costs to keep one car in the hospital garage to use the car as storage for food/clothing and choosing to have one parent stay with the child in the PICU to avoid additional costs of food and travel. These compensatory strategies led to additional reports of stress and exhaustion.

CONCLUSIONS: Families bear significant NMOOPEs, demonstrate work absenteeism and inability to perform daily activities with lowest income brackets bearing the highest burden.

CLINICAL IMPLICATIONS: The NMOOPEs incurred by a family during a PICU admission can have significant and long-lasting financial implications. Opportunities exist for PICU staff and hospitals to reduce the burden of NMOOPEs to mitigate the significant financial impact on families.

DISCLOSURE: The following authors have nothing to disclose: Maureen Clark, Brian Cummings, Karen Kuhlthau, Natalie Frassica, Natan Noviski

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