Growth and Changing Characteristics of Pediatric Intensive Care 2001–2016

OBJECTIVES:We assessed the growth, distribution, and characteristics of pediatric intensive care in 2016. DESIGN:Hospitals with PICUs were identified from prior surveys, databases, online searching, and clinician networking. A structured web-based survey was distributed in 2016 and compared with res...

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Published in:	Critical care medicine Vol. 47; no. 8; pp. 1135 - 1142
Main Authors:	Horak, Robin V., Griffin, John F., Brown, Ann-Marie, Nett, Sholeen T., Christie, LeeAnn M., Forbes, Michael L., Kubis, Sherri, Li, Simon, Singleton, Marcy N., Verger, Judy T., Markovitz, Barry P., Burns, Jeffrey P., Chung, Sarita A., Randolph, Adrienne G.
Format:	Journal Article
Language:	English
Published:	United States by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc 01-08-2019 Copyright by by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc
Subjects:	Adolescent Child Critical Care - organization & administration Critical Care - trends Female Health Care Rationing - organization & administration Health Care Rationing - trends Hospital Bed Capacity - statistics & numerical data Humans Intensive Care Units, Pediatric - organization & administration Intensive Care Units, Pediatric - trends Length of Stay - trends United States United States
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Summary:	OBJECTIVES:We assessed the growth, distribution, and characteristics of pediatric intensive care in 2016. DESIGN:Hospitals with PICUs were identified from prior surveys, databases, online searching, and clinician networking. A structured web-based survey was distributed in 2016 and compared with responses in a 2001 survey. SETTING:PICUs were defined as a separate unit, specifically for the treatment of children with life-threatening conditions. PICU hospitals contained greater than or equal to 1 PICU. SUBJECTS:Physician medical directors and nurse managers. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:PICU beds per pediatric population (< 18 yr), PICU bed distribution by state and region, and PICU characteristics and their relationship with PICU beds were measured. Between 2001 and 2016, the U.S. pediatric population grew 1.9% to greater than 73.6 million children, and PICU hospitals decreased 0.9% from 347 to 344 (58 closed, 55 opened). In contrast, PICU bed numbers increased 43% (4,135 to 5,908 beds); the median PICU beds per PICU hospital rose from 9 to 12 (interquartile range 8, 20 beds). PICU hospitals with greater than or equal to 15 beds in 2001 had significant bed growth by 2016, whereas PICU hospitals with less than 15 beds experienced little average growth. In 2016, there were eight PICU beds per 100,000 U.S. children (5.7 in 2001), with U.S. census region differences in bed availability (6.8 to 8.8 beds/100,000 children). Sixty-three PICU hospitals (18%) accounted for 47% of PICU beds. Specialized PICUs were available in 59 hospitals (17.2%), 48 were cardiac (129% growth). Academic affiliation, extracorporeal membrane oxygenation availability, and 24-hour in-hospital intensivist staffing increased with PICU beds per hospital. CONCLUSIONS:U.S. PICU bed growth exceeded pediatric population growth over 15 years with a relatively small percentage of PICU hospitals containing almost half of all PICU beds. PICU bed availability is variable across U.S. states and regions, potentially influencing access to care and emergency preparedness.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0090-3493 1530-0293
DOI:	10.1097/CCM.0000000000003863