AMITA Health Saint Mary Hospital near Chicago’s Ukrainian Village neighborhood wants to close its pediatric unit, the latest in a parade of hospitals across the region — and the country — to do so.
On an average day in 2019, St. Mary had just one child admitted, and only 134 kids the entire year, according to an application AMITA filed with Illinois regulators. AMITA, which is one of the biggest health systems in Illinois, documented a steady decrease in pediatric admissions over the years.
“After much thought and consideration, we feel our community will be better served in converting these needed beds into a general inpatient medical/surgical unit,” Bob Dahl, president and CEO of Saints Mary and Elizabeth Medical Center (the two nearby hospitals are branded as one), wrote in a statement.
The majority of St. Mary’s patients are Latino or Black. More than one-third of patients are on Medicaid, the government health insurance program for low-income and disabled people, the latest state data shows.
The Illinois Health Facilities and Services Review Board, which regulates the health care industry to prevent duplication of services, must approve AMITA’s request.
If approved, St. Mary will continue to treat children who show up in the emergency room, but transfer them to other hospitals in the area if they need to be hospitalized. St. Mary also will continue to offer certain pediatric outpatient services.
Pediatric beds are disappearing across the U.S.
St. Mary’s proposal illustrates a trend that’s been happening for years across the country. Dr. Matthew Davis, the lead pediatrician at Lurie Children’s Hospital, a regional destination in downtown Streeterville for the sickest children, explains some of what’s driving this.
For one, more children are getting vaccinated against the flu and pneumonia, which used to send more kids to the hospital. More doctors are adding to the types of vaccines they’re giving children, such as those that have helped cut down on the number of kids hospitalized for diarrhea and dehydration.
And doctors are doing a better job of treating kids who have chronic medical conditions such as diabetes and asthma. That keeps flare ups at bay that in the past could have meant hospital time.
The result is that many community hospitals are seeing fewer kids who need to be hospitalized and therefore winding down their pediatric units to treat more adults instead.
Despite the new reality, Davis calls the shift concerning. He’s been studying the trend locally and its impact.
“What we’ve wanted to understand is the circumstances that drive hospitals to make this decision, that does affect the access the families have to hospital-level care for their children near where they live,” Davis said. “It’s a challenging balance to strike, because we know that it’s very hard to sustain high-quality, safe inpatient care for kids at hospitals that have very low volumes. But we also want to try to optimize things for parents.”
In 2019, hospitals across Illinois used just over 1,000 total pediatric beds at their busiest times, according to the most recent state data. That year, there were 31,325 pediatric admissions.
Four years earlier, there were 155 more beds available for children and nearly 12,000 more pediatric admissions to hospitals.
While there’s an overall drop in the number of kids being hospitalized, some larger hospitals that typically treat a lot of children are still just as busy, or getting busier. Community hospitals are transferring and referring kids to those larger hospitals, Davis said.
At Lurie, that’s meant adding about 25% more hospital beds since the medical center opened nearly a decade ago. There are now around 360 beds at Lurie’s downtown tower.
“We quickly realized that was not enough to meet the needs of the Chicagoland area and beyond,” Davis said.
Nearly all of the additional beds are in intensive care.
What this means for parents and their kids
In general, it’s unusual for kids to be hospitalized, said Dr. Edward Pont, chairman of government affairs for the Illinois chapter of the American Academy of Pediatrics and a local pediatrician.
But as community hospitals wind down their pediatric care, there could be barriers for parents and their children. Traveling further to another hospital can be inconvenient and expensive — consider a pricey parking garage downtown — and scary at a time when parents and their kids are particularly vulnerable.
“You take a parent at one of their most vulnerable moments, where you say to them, ‘Your child is so fragile they have to go into the hospital now. Your care will be with another doctor,’” Pont said. “I have yet to find the least bad way to let a parent know that.”
But he emphasized that sending kids to a hospital with physicians who specialize in pediatrics is where they’ll get the best care.
“The way you give quality care and the way you avoid error is to do the care over and over and over,” Pont said.
Davis underscored another need: that all hospitals are still prepared to treat sick or injured children when they show up in the emergency room, regardless of whether the hospitals still admit the youngest patients.
Kristen Schorsch covers public health on WBEZ’s government and politics desk. Follow her @kschorsch.