children’s hospitals
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A study recently published in JAMA Pediatrics assessed the current situation to accessing treatment for children, in terms of accessibility of children’s hospitals or regional hospitals.

The department that treats the ailments and abnormal conditions found in children is called Paediatrics. Over the past decade, there has been a significant increase in a number of people, both adults and children that receive care in central specialized hospitals.

Specialized children’s hospitals may present some advantages to patients by providing specialized, expert care.Certain conditions present in patients need to be managed by more than one health centre due to many of specialized services not being in one place. This might be harmful due to increased travel times and may lead to a reduction in good patient outcomes. This is especially true of patients who are children and require more than one speciality for a large majority of conditions.

To test the hypothesis that the availability of specialized pediatric care is more limited than adult care, a study was conducted by the researchers at Division of Critical Care, Department of Anesthesia, Perioperative, and Pain Medicine at Harvard University. Clinical researchers França, Urbano L., and Michael L. McManus investigated the assumption that the availability of definitive children’s hospital care is inadequate in comparison to adult care and are decreasing disproportionately. Their results were published in JAMA Pediatrics.

For the purpose of this study, the researchers examined the frequency of hospital transfers and the site of completion of care for all the acute center hospitals in the state of Massachusetts. This was conducted between the years of 2004 to 2014 and included 34,511,312 patient encounters.

The results of this study demonstrated that care for children is definitely more centralized when compared to adults. Furthermore, it was noticed that the need for specialized care for children increased by 36.2 percent during that decade. Additionally, the researchers found that there is comparatively little or no care present in some community centers and various regional health outposts for children. Both of these circumstances could potentially lead to a decrease in the quality and effectiveness of child care.

One of the reasons for this concentrated care was the lack of appropriate treatment measures at non-academic hospitals. These measures may be in terms of lack of facilities or trained personnel at the non-academic centers. This deficiency may cause children in distant regions to not report to the children’s hospitals due to long travel times, making child care inaccessible in those areas and thus decreasing the overall health of the child population within the US. The authors propose that there may need to be an increase in the amount of basic services in the community and regional health centers to increase the amount of health care so that many children across the US will have access to care.

This study is the first of its kind to quantitatively describe an entire states existing network of pediatric care.  These important findings have implications for families selecting care plans, regulators and lawmakers, and government officials responsible for emergency preparedness plans.

Written by Dr. Apollina Sharma, MBBS, GradDip EXMD

França, Urbano L., and Michael L. McManus. “Availability of Definitive Hospital Care for Children.” JAMA Pediatrics (2017): e171096-e171096.

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