Alan A Woodall, Aseel S Abuzour, Samantha A Wilson, Frances S Mair, Iain Buchan, Sally B Sheard, Paul Atkinson, Dan W Joyce, Pyers Symon, Lauren E Walker
Management of antipsychotics in primary care: Insights from healthcare professionals and policy makers in the United Kingdom
PloS one
national analyses suggest approximately 1 5 us hospitals closed pediatric units 2008 2018 extent pediatric hospitalizations general hospitals rural urban communities decreased period well understood describe changes number proportion pediatric hospitalizations costs urban teaching urban nonteaching rural hospitals vs freestanding childrens hospitals 2009 2019 estimate number proportion hospitals providing inpatient pediatric care characterize changes clinical complexity study retrospective crosssectional analysis 2009 2012 2016 2019 kids inpatient database nationally representative data set us pediatric hospitalizations among children younger 18 years data analyzed february june 2023 pediatric hospitalizations grouped birth nonbirth hospitalizations hospitals categorized freestanding childrens hospitals rural urban nonteaching urban teaching general hospitals primary outcomes annual number proportion birth nonbirth hospitalizations health care costs changes proportion hospitalizations complex diagnoses estimated number proportion hospitals providing pediatric care associated hospital volumes regression analyses used compare health care utilization 2019 vs 2009 data included 232 million 95 ci 227236 million weighted hospitalizations 2009 2019 estimated national annual pediatric hospitalizations decreased 6 425 858 5 297 882 birth hospitalizations decreased 106 95 ci 61151 nonbirth hospitalizations decreased 289 95 ci 213365 concurrently hospitalizations complex chronic disease diagnoses increased 455 95 ci 346564 hospitalizations mental health diagnoses increased 780 95 ci 616944 period substantial decreases nonbirth hospitalizations rural hospitals 4fold decrease 229 263 62 729 urban nonteaching hospitals 6fold decrease 581 320 92 118 2019 birth hospitalizations occurred 2666 hospitals nonbirth pediatric hospitalizations occurred 3507 hospitals including 1256 rural hospitals 843 urban nonteaching hospitals median nonbirth hospitalization volumes fewer 25 per year 2009 2019 largest decreases pediatric hospitalizations occurred rural urban nonteaching hospitals clinical policy initiatives support hospitals low pediatric volumes may needed maintain hospital access pediatric readiness particularly rural communities