Fewer U.S. hospitals can care for children

Fewer U.S. hospitals can care for children
From Reuters - July 14, 2017

In Massachusetts, a child who winds up in an emergency room - whether for a routine or a serious problem - is likely to be transferred to a second hospital for care, a potentially concerning trend thats being reported by physicians throughout the United States, researchers say.

At the root, they maintain, is the disappearance of pediatric community hospital care.

The number of children transferred from one hospital to another increased by more than 36 percent in Massachusetts from 2004 to 2014, and only about 20 percent of the states 66 hospitals completed care for more than half of their pediatric patients without transferring them, the research team reports in JAMA Pediatrics.

Pediatric hospital care is less available than it used to be, mostly because community hospitals are increasingly transferring children to larger centers, said senior author Dr. Michael McManus, a pediatrician and professor at Harvard Medical School in Boston.

Transfer can greatly improve care for some conditions, he said in an email, but can delay and potentially worsen care for others.

The research showed consolidation of care into regional centers for both adults and children over the decade studied. But the move to regional care for children far outpaced that for adults.

The likelihood of a hospital completing a childs care without a transfer dropped by 65 percent from 2004 to 2014, while the likelihood of a hospital completing an adults care without a transfer fell by 11 percent, the study found.

Dr. Nicholas Mohr, a professor at the University of Iowa Carver College of Medicine in Iowa City, said doctors have seen the trend in hospitals throughout the U.S. But the number of children transferred between Massachusetts hospitals surprised him.

Fewer children are being cared for in community hospitals, he said in a phone interview. The big question is whether thats good or bad.

We dont know what the outcome differences are. Thats the million-dollar question, said Mohr, who was not involved in the study.

Altogether, the researchers analyzed more than 34 million emergency department as well as inpatient and observation admissions, using data from every acute-care hospital in Massachusetts for 10 years.


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