Introduction:
Length of inpatient hospitalization for pediatric burn patients varies based on burn severity, size and presence of inhalation and other injuries. The BEACON model was developed in 2018 using National Burn Repository (NBR) data to help providers make assessments of the resource allocations and costs associated with new technologies in burn care. The new innovation autologous skin cell suspension (ASCS) was the first technology evaluated in BEACON which projected significant cost savings projections in the treatment of severe burns with ASCS compared to the standard of care. The largest projected cost reductions from the use of ASCS came from reductions in length of stay (LOS). Our study seeks to confirm these results by performing a multicenter, real-world data (RWD) analysis of LOS and resulting costs for pediatric patients treated with ASCS vs. standard of care (SOC) and through the review of pediatric cases. This data will be compared to a Pediatric Burn Center’s experience and challenges with LOS.

Methods:
De-identified electronic medical record data was collected over a 20-month period (1/2019 to 8/2020) from 43 burn centers in 14 states. Patients with burn injuries treated with ASCS were matched by age, sex, total body surface area (TBSA), and comorbidities to patients treated with current SOC. Injury severity was calculated as categorical data across intervals of TBSA sizes. Cost analysis was determined using data from prior peer-reviewed literature in burn care. These data will be then compared to a single pediatric burn center’s findings.

Results:
A total of 2,243 patients were reviewed and used in a matched cohort analysis. In these patients, 20% had < 20% TBSA. Compared to SOC, ASCS patients had a shorter LOS. At an assumed overall per patient hospital bed cost of $8,362 per day, these differences in LOS produced a savings in hospital bed costs alone per ASCS patient versus SOC. LOS was shorter for ASCS patients in of cases resulting in overall hospital bed cost savings of for ASCS-treated patients compared to SOC. Clinical case review demonstrated a range of LOS consistent with RWD findings for patients treated with ASCS as compared to SOC. Reviewed cases provided additional insight into factors impacting LOS in pediatric burn patients.

Conclusions:
This study represents the first RWD cost-effectiveness analysis to-date in pediatric burn patients treated with ASCS vs SOC. These results confirm the BEACON model projections with savings primarily originating from reductions in LOS. Cost savings were also found in patients having small burns of <20% TBSA. Challenges and impacting factors for pediatric units will be explored and discussed against how they differ from that national findings.