Objective

Our objective was to understand the market characteristics related to closures of licensed pediatric hospital beds that may be related to increasing regionalization of pediatric hospital care.

Methods

We performed a retrospective descriptive analysis of 110 hospitals with licensed pediatric hospital beds from a statewide survey of health care facilities (2012–2017) and administrative data of hospital admissions (2013–2018) in Illinois. We quantified closures of licensed pediatric hospital beds and categorized hospital bed closures by hospital and market characteristics.

Results

From 2012 through 2017, the number of licensed pediatric beds declined from 1706 to 1254 (-26.5%). Over the same time period, annual pediatric inpatient days minimally changed (+1.1%), while annual pediatric inpatient days at hospitals affiliated with the Children's Hospital Association increased (+30.5%). After accounting for re-openings, the 33 hospitals that closed all licensed pediatric beds fit 4 distinct typologies: 1) Hospitals with minimal pediatric volume throughout the study (n = 19); 2) Hospitals that sustained at least 50% of their pediatric volume after closure of licensed pediatric beds (n = 8); 3) Hospitals with low market share in metropolitan areas (n = 5); and 4) Hospital with a decline in pediatric market share, while a nearby hospital saw a corresponding rise in pediatric market share (n = 1).

Conclusions

In Illinois, licensed pediatric hospital beds declined while pediatrics inpatient days stayed the same over a recent 6-year period. Typologies of closures describe the nuanced dynamics leading to decline of pediatric hospital beds. Understanding these patterns is critical to ensure that children receive quality pediatric-tailored care.

中文翻译：

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关闭伊利诺伊州医疗保健市场中获得许可的儿科病床

客观的

我们的目标是了解与关闭有执照的儿科医院床位相关的市场特征，这可能与儿科医院护理区域化程度的提高有关。

方法

我们对伊利诺伊州全州医疗机构调查（2012-2017 年）和住院管理数据（2013-2018 年）的 110 家拥有儿科病床许可的医院进行了回顾性描述性分析。我们量化了获得许可的儿科病床的关闭情况，并根据医院和市场特征对关闭的病床进行了分类。

结果

从 2012 年到 2017 年，获得许可的儿科病床数量从 1706 张下降到 1254 张（-26.5%）。在同一时期，每年儿科住院天数变化很小 (+1.1%)，而儿童医院协会附属医院的年儿科住院天数增加 (+30.5%)。考虑到重新开业后，关闭所有获得许可的儿科病床的 33 家医院符合 4 种不同的类型：1) 在整个研究过程中儿科手术量最少的医院 (n = 19)；2) 在关闭获得许可的儿科病床后至少维持 50% 儿科手术量的医院 (n = 8)；3) 大城市地区市场份额较低的医院（n = 5）；4) 儿科市场份额下降的医院，而附近一家医院的儿科市场份额相应上升 (n = 1)。

结论

在伊利诺斯州，获得许可的儿科医院床位在最近 6 年期间有所减少，而儿科住院天数保持不变。关闭的类型描述了导致儿科病床减少的微妙动态。了解这些模式对于确保儿童获得优质的儿科定制护理至关重要。