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Growth and Changing Characteristics of Pediatric Intensive Care 2001-2016.
Crit Care Med. 2019 08; 47(8):1135-1142.CC

Abstract

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.

Authors+Show Affiliations

Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA. Department of Pediatrics, Keck School of Medicine, Los Angeles, CA.Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA.Critical Care Medicine, Akron Children's Hospital, Akron, OH. School of Nursing at Emory University, Atlanta, GA.Department of Pediatrics, Children's Hospital at Dartmouth, Lebanon, NH.PICU/Respiratory Rehabilitation Unit, Dell Children's Medical Center of Central Texas, Austin, TX.Critical Care Medicine, Akron Children's Hospital, Akron, OH.Department of Nursing, Children's Hospital of Philadelphia, Philadelphia, PA.Pediatric Critical Care Medicine, Maria Fareri Children's Hospital, New York Medical College, Valhalla, NY. Department of Pediatrics, New York Medical College, Valhalla, NY.Department of Pediatrics, Children's Hospital at Dartmouth, Lebanon, NH.Department of Nursing, Children's Hospital of Philadelphia, Philadelphia, PA.Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA. Department of Pediatrics, Keck School of Medicine, Los Angeles, CA.Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA. Departments of Anaesthesia, Harvard Medical School, Boston, MA.Department of Pediatrics, Harvard Medical School, Boston, MA. Division of Emergency Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA.Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA. Departments of Anaesthesia, Harvard Medical School, Boston, MA. Department of Pediatrics, Harvard Medical School, Boston, MA.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31162205

Citation

Horak, Robin V., et al. "Growth and Changing Characteristics of Pediatric Intensive Care 2001-2016." Critical Care Medicine, vol. 47, no. 8, 2019, pp. 1135-1142.
Horak RV, Griffin JF, Brown AM, et al. Growth and Changing Characteristics of Pediatric Intensive Care 2001-2016. Crit Care Med. 2019;47(8):1135-1142.
Horak, R. V., Griffin, J. F., Brown, A. M., Nett, S. T., Christie, L. M., Forbes, M. L., Kubis, S., Li, S., Singleton, M. N., Verger, J. T., Markovitz, B. P., Burns, J. P., Chung, S. A., & Randolph, A. G. (2019). Growth and Changing Characteristics of Pediatric Intensive Care 2001-2016. Critical Care Medicine, 47(8), 1135-1142. https://doi.org/10.1097/CCM.0000000000003863
Horak RV, et al. Growth and Changing Characteristics of Pediatric Intensive Care 2001-2016. Crit Care Med. 2019;47(8):1135-1142. PubMed PMID: 31162205.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Growth and Changing Characteristics of Pediatric Intensive Care 2001-2016. AU - Horak,Robin V, AU - Griffin,John F, AU - Brown,Ann-Marie, AU - Nett,Sholeen T, AU - Christie,LeeAnn M, AU - Forbes,Michael L, AU - Kubis,Sherri, AU - Li,Simon, AU - Singleton,Marcy N, AU - Verger,Judy T, AU - Markovitz,Barry P, AU - Burns,Jeffrey P, AU - Chung,Sarita A, AU - Randolph,Adrienne G, AU - ,, PY - 2019/6/5/pubmed PY - 2020/4/17/medline PY - 2019/6/5/entrez SP - 1135 EP - 1142 JF - Critical care medicine JO - Crit Care Med VL - 47 IS - 8 N2 - 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. SN - 1530-0293 UR - https://www.unboundmedicine.com/medline/citation/31162205/Growth_and_Changing_Characteristics_of_Pediatric_Intensive_Care_2001_2016_ L2 - https://dx.doi.org/10.1097/CCM.0000000000003863 DB - PRIME DP - Unbound Medicine ER -