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Inpatient Pediatric Care and Clinician Workforce in Wisconsin: The State of the State
Samantha Busch1, Ann Allen2, Jen Birstler3
1University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Insights
Inpatient pediatric services are available in Wisconsin hospitals, including critical access facilities, despite workforce shortages. Family physicians are crucial for pediatric care delivery, especially in rural areas.
Area of Science:
- Pediatric Healthcare Delivery
- Rural Health Services
- Physician Workforce Analysis
Background:
- National decline in inpatient pediatric services from 2008-2018, with rural areas most affected.
- Most children receive care in community hospitals, not specialized children's centers.
- Assessing Wisconsin's pediatric care is vital for meeting children's health needs.
Purpose of the Study:
- To determine the availability of inpatient pediatric services in Wisconsin.
- To identify the physician workforce providing these services.
- To understand pediatric care delivery in various hospital types, including critical access hospitals.
Main Methods:
- Cross-sectional survey distributed to Wisconsin hospitals.
- Response rate of 94% (130/138 hospitals), including 97% of critical access hospitals.
- Descriptive statistical analysis of inpatient pediatric service data and physician staffing.
Main Results:
- Newborn and general pediatric care primarily staffed by pediatricians and family physicians.
- Critical access hospitals rely heavily on family physicians for pediatric services.
- Neonatal intensive care units are staffed by neonatologists; telemedicine is used in critical access hospitals.
Conclusions:
- Wisconsin hospitals, including critical access facilities, maintain inpatient pediatric services despite workforce challenges.
- Family physicians are integral to pediatric healthcare delivery across Wisconsin.
- Enhanced pediatric training for family physicians can help address accessibility gaps in rural areas.
Introduction:
Availability of inpatient pediatric services declined across the United States from 2008 through 2018, with rural areas experiencing steepest declines. Despite the movement of pediatric care to children's centers, most children are still cared for in community hospitals nationally. Assessing the availability and providers of inpatient pediatric care in Wisconsin is an important step in ensuring the health care needs of children in the state continue to be met.
Methods:
A cross-sectional survey was distributed to Wisconsin hospitals to determine pediatric services and physician workforce. The response rate was 130/138 (94%), including 56/58 (97%) critical access hospitals. Results of specific inpatient pediatric subdivisions were analyzed by descriptive statistics.
Results:
Hospitals that provide inpatient newborn care are mostly staffed by pediatricians and family physicians, while critical access hospitals are staffed by family physicians. Hospitals with neonatal intensive care units are staffed by neonatologists, with telemedicine utilized in critical access hospitals. Hospitals with general pediatric admissions are staffed by pediatricians or family physicians, while critical access hospitals are staffed by family physicians. Hospitals with pediatric intensive care units are staffed by pediatric intensivists.
Conclusions:
Despite workforce disparities and shortages, hospitals across Wisconsin, including many critical access hospitals, continue to provide inpatient pediatric services. Family physicians play a major role in the pediatric health care delivery in Wisconsin hospitals. Robust inpatient pediatric training of family physicians may enable rural health authorities to continue addressing the gaps that persist in inpatient pediatric care accessibility.
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