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Pediatrics
One-Hour Concurrent Session

Meeting the Dynamic Needs of the Pediatric ICU Population: Regionalization, Resources, and Capacity

Monday, February 24, 2025
9:45am – 10:45am Eastern Time
Location: W311E
CE: 1

The number of children in ICUs is rising, along with their complexity; they have more multiorgan failure, use more resources, and stay longer. More children rely on public insurance. Increasing regionalization from general ICUs in community hospitals to children’s hospitals results in a higher concentration of expensive patients in a smaller number of centers and increased PICU bed capacity in children’s hospitals. Regionalization may be associated with less timely access to care. The distance to the nearest pediatric inpatient unit increased for nearly one-quarter of U.S. children between 2010 and 2018, mostly in rural areas. These trends suggest that ICU specialization for children may be beneficial for patients but makes high demands on hospitals. The U.S. healthcare system must care for an increasingly complex patient mix, ensure timely access to care, assess costs and risks of increasingly common interhospital transfers, and prepare for crises and surges. Speakers represent U.S. and international perspectives, healthcare delivery experts and researchers, and general and critical care pediatricians. They will discuss strategies for reducing disparities in pediatric critical care access and preparing healthcare systems for anticipated capacity and resource needs.

Learning Objectives:

  • Describe changes in U.S. critically ill children over time and the implications of these changes for U.S. healthcare capacity
  • Contrast the epidemiologic trends among U.S. critically ill children to those in other parts of the world
  • Identify strategies for improving transitions of care for children with medical complexity across outpatient, community hospital, and tertiary care environments
  • Describe the impact of closure of inpatient pediatric units and regionalization of care to children’s hospitals on access to pediatric general and intensive care for U.S. children
  • identify strategies to provide care for children across different care environments during times of surge or crisis and limited ICU resource capacity

Presentations:

  • 9:50am – 10:05am Eastern Time
    The Changing Epidemiology of Pediatric Critical Care Access, Delivery, and Outcomes in the United States

    Elizabeth Y. Killien, MD, MPH (she/her/hers) – Seattle Children's Hospital

  • 10:05am – 10:20am Eastern Time
    The New Normal: Providing Chronic Critical Care for the Medically Complex Child

    Robert Graham, MD (he/him/his) – Boston Children’s Hospital

  • 10:20am – 10:35am Eastern Time
    Caring for Children in Times of Crisis: Surge Capacity Planning and Response for Increasingly Complex and Severely Ill Children

    Mary King, MD, MPH (she/her/hers) – UW Medicine Harborview Medical Center