From 2008 to 2018, there was a decrease in pediatric inpatient capacity and an increase in pediatric intensive care unit (PICU) beds, according to a study published online June 14 in Pediatrics.
Anna M. Cushing, M.D., from Boston Children’s Hospital, and colleagues examined trends in pediatric inpatient capacity in a retrospective study of 4,720 U.S. hospitals using data from the 2008 to 2018 American Hospital Association Survey. Trends in pediatric inpatient care and PICU capacity were described.
The researchers observed a 19.1 percent decrease in pediatric inpatient units (34 units/year) and an 11.8 percent decrease in pediatric inpatient beds (407 beds/year). A 16.0 percent increase was seen in PICU beds (66.9 beds/year), mainly at children’s hospitals. Steeper proportional declines were seen in pediatric inpatient beds in rural areas (−26.1 versus −10.0 percent). Most states experienced decreases in pediatric inpatient beds and pediatric inpatient days (median state, −18.5 and −10.0 percent, respectively). An increase in distance to their nearest pediatric inpatient unit was experienced by nearly one-quarter of U.S. children. The highest risk for closing was seen for low-volume pediatric units and those without an associated PICU.
“The trend is clear: Pediatric inpatient care is more regionalized and concentrated,” write the authors of an accompanying editorial. “Intensive care beds are increasingly utilized, and the reason for that may be partly a financial response to decreased reimbursement, rather than increased need for intensive care services.”