Paige VonAchen1, Matthew M Davis2, Jenifer Cartland3, Amy D'Arco3, Kristin Kan2. 1. Mary Ann & J. Milburn Smith Child Health Outreach, Research and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago (P VonAchen, MM Davis, J Cartland, A D'Arco, and K Kan), Chicago, Ill; University of Michigan Medical School (P VonAchen), Ann Arbor, Mich. Electronic address: Paige.vonachen@childrens.harvard.edu. 2. Mary Ann & J. Milburn Smith Child Health Outreach, Research and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago (P VonAchen, MM Davis, J Cartland, A D'Arco, and K Kan), Chicago, Ill; Division of Advanced General Pediatrics and Primary Care, Department of Pediatrics, Northwestern University Feinberg School of Medicine (MM Davis and K Kan), Chicago, Ill. 3. Mary Ann & J. Milburn Smith Child Health Outreach, Research and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago (P VonAchen, MM Davis, J Cartland, A D'Arco, and K Kan), Chicago, Ill.
Abstract
OBJECTIVE: Our objective was to understand the market characteristics related to closures of licensed pediatric hospital beds that may be related to increasing regionalization of pediatric hospital care. METHODS: We performed a retrospective descriptive analysis of 110 hospitals with licensed pediatric hospital beds from a statewide survey of health care facilities (2012-2017) and administrative data of hospital admissions (2013-2018) in Illinois. We quantified closures of licensed pediatric hospital beds and categorized hospital bed closures by hospital and market characteristics. RESULTS: From 2012 through 2017, the number of licensed pediatric beds declined from 1706 to 1254 (-26.5%). Over the same time period, annual pediatric inpatient days minimally changed (+1.1%), while annual pediatric inpatient days at hospitals affiliated with the Children's Hospital Association increased (+30.5%). After accounting for re-openings, the 33 hospitals that closed all licensed pediatric beds fit 4 distinct typologies: 1) Hospitals with minimal pediatric volume throughout the study (n = 19); 2) Hospitals that sustained at least 50% of their pediatric volume after closure of licensed pediatric beds (n = 8); 3) Hospitals with low market share in metropolitan areas (n = 5); and 4) Hospital with a decline in pediatric market share, while a nearby hospital saw a corresponding rise in pediatric market share (n = 1). CONCLUSIONS: In Illinois, licensed pediatric hospital beds declined while pediatrics inpatient days stayed the same over a recent 6-year period. Typologies of closures describe the nuanced dynamics leading to decline of pediatric hospital beds. Understanding these patterns is critical to ensure that children receive quality pediatric-tailored care.
OBJECTIVE: Our objective was to understand the market characteristics related to closures of licensed pediatric hospital beds that may be related to increasing regionalization of pediatric hospital care. METHODS: We performed a retrospective descriptive analysis of 110 hospitals with licensed pediatric hospital beds from a statewide survey of health care facilities (2012-2017) and administrative data of hospital admissions (2013-2018) in Illinois. We quantified closures of licensed pediatric hospital beds and categorized hospital bed closures by hospital and market characteristics. RESULTS: From 2012 through 2017, the number of licensed pediatric beds declined from 1706 to 1254 (-26.5%). Over the same time period, annual pediatric inpatient days minimally changed (+1.1%), while annual pediatric inpatient days at hospitals affiliated with the Children's Hospital Association increased (+30.5%). After accounting for re-openings, the 33 hospitals that closed all licensed pediatric beds fit 4 distinct typologies: 1) Hospitals with minimal pediatric volume throughout the study (n = 19); 2) Hospitals that sustained at least 50% of their pediatric volume after closure of licensed pediatric beds (n = 8); 3) Hospitals with low market share in metropolitan areas (n = 5); and 4) Hospital with a decline in pediatric market share, while a nearby hospital saw a corresponding rise in pediatric market share (n = 1). CONCLUSIONS: In Illinois, licensed pediatric hospital beds declined while pediatrics inpatient days stayed the same over a recent 6-year period. Typologies of closures describe the nuanced dynamics leading to decline of pediatric hospital beds. Understanding these patterns is critical to ensure that children receive quality pediatric-tailored care.
Authors: Jeffrey D Colvin; Matt Hall; Laura Gottlieb; Jessica L Bettenhausen; Samir S Shah; Jay G Berry; Paul J Chung Journal: JAMA Pediatr Date: 2016-02 Impact factor: 16.193
Authors: JoAnna K Leyenaar; Shawn L Ralston; Meng-Shiou Shieh; Penelope S Pekow; Rita Mangione-Smith; Peter K Lindenauer Journal: J Hosp Med Date: 2016-07-04 Impact factor: 2.960