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"Where have all the children gone"? Inpatient pediatric care in Connecticut
J D Thompson1, K H Lee, J T Lynch
1Department of Epidemiology and Public Health, School of Nursing, Yale University.
Insights
Pediatric hospital admissions in Connecticut declined significantly between 1981 and 1991, indicating unplanned regionalization of care. This trend necessitates planning that considers case-mix, cost, and quality for low-volume pediatric units.
Area of Science:
- Pediatric Healthcare Management
- Health Services Research
- Hospital Administration
Background:
- Child hospital admissions in Connecticut experienced a sharp decline from 1981 to 1991.
- The regionalization of pediatric inpatient services is occurring without a clear strategic plan.
- This shift impacts the landscape of pediatric care delivery within the state.
Purpose of the Study:
- To analyze trends in pediatric hospital admissions in Connecticut.
- To examine changes in the case-mix of pediatric patients.
- To inform future planning for pediatric inpatient services.
Main Methods:
- Retrospective analysis of Connecticut hospital admission data from 1981 to 1991.
- Examination of pediatric case-mix, focusing on surgical and mental illness categories.
- Assessment of trends in pediatric inpatient utilization.
Main Results:
- A significant decrease in overall pediatric hospital admissions was observed.
- A notable shift in the case-mix of pediatric cases, particularly in surgery and child mental health.
- Evidence suggests a de facto regionalization of pediatric care without deliberate planning.
Conclusions:
- Pediatric inpatient services are regionalizing organically, highlighting a need for strategic planning.
- Future planning must incorporate case-mix, cost-effectiveness, and quality of care.
- Special attention is required for general hospital pediatric units with very low patient volumes.
Abstract:
Admission of children to hospitals in Connecticut dropped precipitously from 1981 to 1991. Regionalization of pediatric inpatient care is happening without plan. Connecticut data show a change in case-mix of pediatric cases, especially in surgical services and child mental illness categories. Planning for pediatric inpatient services should include considerations of case-mix, cost, and especially, quality of care in general hospital pediatric units with very low volume.