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.
Keywords
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Article Info
Publication History
Published online: June 25, 2021
Accepted:
June 19,
2021
Received:
October 1,
2020
Identification
Copyright
Copyright © 2021 by Academic Pediatric Association
