Multi-Hospital Pediatric Surge Response to an RSV Epidemic in a US State: Oregon, 2022

Abstract Importance There is limited data describing statewide pediatric surge response during times of capacity strain. Objective Characterize the burden and response to a surge in pediatric respiratory admissions in Oregon in 2022. Design, Setting, and Participants This analysis utilized data from the Oregon Capacity System (OCS) and the state discharge database to describe patient characteristics, census changes, and admission pattern shifts during an RSV epidemic in 2022. Main Outcome and Measure Statewide pediatric census, weekly pediatric admissions, weekly admissions from non-children’s hospital emergency departments (EDs) to non-children’s hospitals. Results The median census in Oregon’s pediatric inpatient hospitals increased by 19% during the surge period (306 vs 364, P < 0.001), while the median pediatric intensive care unit census increased by 50% (24 vs 36, P < 0.001). Weekly elective pediatric admissions to children’s hospitals decreased by 33% (30 vs 20, P = 0.03). ED admissions to non-children’s hospitals increased by 160% (15 vs 39 per week, P = 0.02). Conclusion and Relevance As the statewide pediatric inpatient census increased, targeted reductions in elective admissions and increased utilization of non-children’s hospitals increased capacity during a respiratory surge. This analysis underscores the importance of real-time situational awareness and coordinated surge response between hospitals.