Original Articles
Growth of pediatric intensive care units in the United States from 1995 to 2001

https://doi.org/10.1016/j.jpeds.2004.03.019Get rights and content

Abstract

Objective

To describe the growth and distribution of pediatric intensive care unit (PICU) beds in the United States from 1995 to 2001 and the characteristics of PICUs in 2001.

Study design

This was a cross-sectional survey of PICUs in 1995 to 1996 and 2001 to 2002.

Results

There were 306 general PICUs in the United States in 1995 and 349 in 2001 (13.7% growth). In both survey periods, approximately half of the PICUs had ≤8 beds. The largest growth (34.4%) was in PICUs with ≥15 beds. There were 3899 PICU beds in 2001 (23.9% increase from 1995), with a mean number of PICU beds per pediatric population (age <18 years) of 1/18,542 in the United States (17.5% increase from 1995). There was an increase in the number of annual admissions, occupancy rate, length of stay, percentage intubated, mortality rate, and number of intensivists per PICU with increasing bed size. In 2001, 94% of PICUs had a pediatric intensivist on staff, and these specialists were in-house at night in 17% of all PICUs and in 30% of PICUs with ≥15 beds.

Conclusions

The number of PICU beds is growing more rapidly than the rate of pediatric population growth. The impetus for this growth is unclear.

Section snippets

Definitions

A PICU is a separate physical facility or unit specifically designated for the treatment of pediatric patients who, because of shock, trauma, or other life-threatening conditions, require intensified, comprehensive observation and care.5 For the purposes of this study, we defined a pediatric intensivist as any one of the following: (a) a pediatrician with subspecialty training in Pediatric Critical Care Medicine and subspecialty certification from the American Board of Pediatrics, (b) a

Number of PICUs and PICU beds in the United States and Puerto Rico

We were able to contact administrators in all hospitals that were designated as potentially having PICUs (391 hospitals in 1995 to 1996 and 518 hospitals in 2001 to 2002). We confirmed the existence of 306 US and 3 Puerto Rican general PICUs in 1995 and 349 US and 5 Puerto Rican general PICUs in 2001. These numbers are lower than the 330 and 463 PICUs reported for the same periods in the AHA survey in part because the definition of PICU used by the AHA included pediatric intensive care services

Discussion

Between 1995 and 2001, we identified a 14% growth in the number of PICUs and a 24% growth in the number of general PICU beds in the United States. Although the number of PICUs and PICU beds varies across the United States, the number of PICU beds in each US census region for the pediatric population served is quite similar. In both 1995 and 2001, almost half of the PICUs had 8 beds or less. The number of PICUs staffed by a pediatric intensive care specialist has risen more than 20%, from 73.2%

References (14)

  • T.S Yeh

    Regionalization of pediatric critical care

    Crit Care Clin

    (1992)
  • G Pearson et al.

    Should paediatric intensive care be centralised? Trent versus Victoria

    Lancet

    (1997)
  • American Hospital Association. AHA Annual Survey Database FY95. Health Forum LLC, editor. [FY95]. 1996....
  • American Hospital Association. AHA Annual Survey Database FY00. Health Forum LLC, editor. [FY00]. 2001....
  • Committee on Hospital Care of the American Academy of Pediatrics and Pediatric Section of the Society of Critical Care Medicine

    Guidelines and levels of care for pediatric intensive care units

    Pediatrics

    (1993)
  • M.M Pollack et al.

    Pediatric intensive care units: results of a national survey

    Crit Care Med

    (1993)
  • Guidelines for pediatric intensive care units

    Crit Care Med

    (1983)
There are more references available in the full text version of this article.

Cited by (134)

View all citing articles on Scopus

Dr Randolph is funded by NIH NHLBI K23 Award HL04278.

View full text