A new study, published in the journal Academic Pediatrics, found that Illinois hospitals reduced licensed pediatric beds by 27 percent from 2012 through 2017, with 33 hospitals cutting all pediatric beds at their facility. The annual pediatric inpatient days remained the same overall in the state during this time but rose 30% among children’s hospitals.
“The pediatric bed closures we see in Illinois reflect the national trend of declining pediatric hospitalizations, likely due to a reduction in infectious diseases from effective childhood immunizations, the continued shift to outpatient treatment for many pediatric illnesses, and a declining population in our state,” said senior author Kristin Kan, MD, MPH, MSc, a pediatrician at Ann & Robert H. Lurie Children’s Hospital of Chicago and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “However, closing licensed pediatric beds at adult hospitals also means that these institutions are no longer required to have qualified pediatric staff at the bedside, even if they might still continue to admit children. We need sustainable policy solutions to ensure that children continue to get high-quality inpatient care, whenever and wherever they are hospitalized.”
To inform policymakers, Dr. Kan and colleagues performed a retrospective descriptive analysis of 110 hospitals with licensed pediatric beds from a statewide survey of healthcare facilities (2012-2017) and administrative data of hospital admissions (2013-2018) in Illinois.
“Our study is unique in that we characterized factors associated with closures of licensed pediatric beds, across the entire state,” said Dr. Kan. “Understanding these patterns is critical to future planning for children’s health care in the state and is needed to better align policies with contemporary clinical patterns.”
Dr. Kan and her colleagues found that 33 hospitals in Illinois closed all licensed pediatric beds had four distinct patterns. Most hospitals (19) had minimal to no pediatric volume prior to their decisions to close their licensed pediatric beds, whereas 8 hospitals maintained at least 50 percent of their pediatric volume after closure of licensed pediatric beds. Five hospitals had low market share in metropolitan areas prior to closure of their beds, and one hospital saw a decline in pediatric market share, while a nearby hospital saw a corresponding rise in pediatric market share.
“Future research should assess the patient-family perspective on the accessibility to pediatric hospital care at their nearby institutions,” said Dr. Kan. “We need to understand what the closure of licensed pediatric beds means for Illinois children and their families and also whether these shifts in availability and pediatric staffing are associated with differences in quality of care, outcomes, and the costs of care.”
Research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through the Stanley Manne Children’s Research Institute. The Manne Research Institute is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report. It is the pediatric training ground for Northwestern University Feinberg School of Medicine. Last year, the hospital served more than 220,000 children from 48 states and 49 countries.