Factors associated with preparedness of the US healthcare system to respond to a pediatric surge during an infectious disease pandemic: Is our nation prepared?

Anthony, Christy; Thomas, Tito Joe; Berg, Bridget M.; Burke, Rita V.; Upperman, Jeffrey S.

doi:10.5055/ajdm.2017.0275

Cited by 14 publications

(9 citation statements)

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“…Currently, the United States is underprepared to adapt to volume surges in pediatric patients, and declining inpatient unit capacity may further impair the system's ability to manage surges during a disaster or pandemic. 12,13,50 New policy strategies could mitigate the effect of inpatient unit closures. First, designating key community centers as "pediatric critical access hospitals" with subsidies or higher reimbursement could encourage vulnerable pediatric centers to remain open.…”

Section: Figurementioning

confidence: 99%

“…[9][10][11] Pediatric disaster simulations predict increases in mortality and the need to lower standards of care during disasterrelated surges of patients with acute and critical illness. 10,12,13 Although such acute surges are rare, they are also unpredictable, as the coronavirus disease 2019 pandemic has revealed. Inpatient unit bed shortages lead to emergency department crowding and decreased availability, safety, and quality of care.…”

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confidence: 99%

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Availability of Pediatric Inpatient Services in the United States

et al. 2021

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OBJECTIVES:We sought to evaluate trends in pediatric inpatient unit capacity and access and to measure pediatric inpatient unit closures across the United States. METHODS:We performed a retrospective study of 4720 US hospitals using the 2008-2018 American Hospital Association survey. We used linear regression to describe trends in pediatric inpatient unit and PICU capacity. We compared trends in pediatric inpatient days and bed counts by state. We examined changes in access to care by calculating distance to the nearest pediatric inpatient services by census block group. We analyzed hospital characteristics associated with pediatric inpatient unit closure in a survival model. RESULTS: Pediatric inpatient units decreased by 19.1% (34 units per year; 95% confidence interval [CI] 31 to 37), and pediatric inpatient unit beds decreased by 11.8% (407 beds per year; 95% CI 347 to 468). PICU beds increased by 16.0% (66.9 beds per year; 95% CI 53 to 81), primarily at children's hospitals. Rural areas experienced steeper proportional declines in pediatric inpatient unit beds (À26.1% vs À10.0%). Most states experienced decreases in both pediatric inpatient unit beds (median state À18.5%) and pediatric inpatient days (median state À10.0%). Nearly one-quarter of US children experienced an increase in distance to their nearest pediatric inpatient unit. Low-volume pediatric units and those without an associated PICU were at highest risk of closing.CONCLUSIONS: Pediatric inpatient unit capacity is decreasing in the United States. Access to inpatient care is declining for many children, particularly those in rural areas. PICU beds are increasing, primarily at large children's hospitals. Policy and surge planning improvements may be needed to mitigate the effects of these changes.

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Section: Figurementioning

confidence: 99%

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confidence: 99%

Availability of Pediatric Inpatient Services in the United States

et al. 2021

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“…A critical component of preparedness plans is surge capacity or the ability to adequately care for a significant influx of patients and be prepared for demands on supplies, personnel and physical space. 6 Although much of disaster and surge capacity planning focuses on hospital-based care, the COVID-19 pandemic required various buildings and structures of opportunity across the country be converted to temporary field hospitals with the goal of increasing health care capacity and capability as needed. 8 The Liacouras Center in Philadelphia was such a structure and rapidly converted to function as an ACS to assist regional health care facilities by providing nonacute care for adults with mildly to moderately symptomatic COVID‐19.…”

Section: Discussionmentioning

confidence: 99%

“…We utilized a previously described conceptual model to assess disaster responses and surge capacity, commonly referred to as the “4S's”: Space, Staff, Stuff, and Systems. 5 , 6 , 7 This framework guided our development of a novel IPC program for this surge facility. In this article, we describe the “4S's” of our program developed for the CSF-L and the related challenges at a COVID-19 ACS.…”

Section: Methodsmentioning

confidence: 99%

Developing and implementing an infection prevention and control program for a COVID-19 alternative care site in Philadelphia, PA

Tadavarthy

Finnegan

Bernatowicz

et al. 2021

American Journal of Infection Control

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Highlights Alternative care sites (ACS) help address surge in response to COVID-19. Infection prevention and control (IPC) expertise is essential for COVID-19 ACSs. A written, comprehensive ACS Health and Safety Plan is a crucial IPC component. The “4S's”: Space, Staff, Stuff, and Systems provides a sound IPC program framework. Continuous ACS IPC program evaluation is critical to success.

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“…Service utilization experiences drawn from the COVID-19 pandemic as well as findings from previous investigations that examined the level of preparedness of the health system in terms of the critical structural capacity in managing the demand for health services, strongly suggest further assessment is necessary to learn about the need and utilization of services in times of pandemic outbreaks. Although previous studies have attempted to demonstrate the level of resource availability [16,17] they do not account for the dynamics of the need generated in the progression of an outbreak or how different components of the health system should feed each other in case of a pandemic emergency. For instance, the established system capacity (e.g., the number of ICU beds, etc.)…”

Section: Healthcare Utilizationmentioning

confidence: 99%

Theoretical and Conceptual Issues in Research Related to Health System Readiness and Response in Pandemic Outbreaks

N¹,

Sanyang²,

Grace³

2021

Int J Healthc Syst Eng

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An accurate assessment of the effectiveness of a health system requires integrative initiatives through its components to establish a system's response to different shocks, including health emergencies such as the COVID-19 pandemic. The focus of this study was to develop a framework for the analysis of the health system readiness and response capacity during a pandemic outbreak. A review of the conceptual and theoretical issues in developing a model for health system analysis and assessment was conducted based on the intersection and interconnectedness of the system components. An integrative modeling framework was developed by incorporating key theories derived from the system fields of preparedness, service utilization, and public health in addressing pandemic outbreaks. Three phases of an outbreak emergency have been identified and linked to integrative response effort from the three disciplines while aiming at achieving common outcome goals. The framework is designed to guide scholars, health system researchers, and policymakers in understanding and applying multidisciplinary approaches to develop effective strategies in response to health emergencies. The distribution of resources in emergencies and in the assessment of the level of preparation of the system should be among key operational processes that could benefit from adopting the context of the framework.

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Factors associated with preparedness of the US healthcare system to respond to a pediatric surge during an infectious disease pandemic: Is our nation prepared?

Cited by 14 publications

References 0 publications

Availability of Pediatric Inpatient Services in the United States

Availability of Pediatric Inpatient Services in the United States

Developing and implementing an infection prevention and control program for a COVID-19 alternative care site in Philadelphia, PA

Theoretical and Conceptual Issues in Research Related to Health System Readiness and Response in Pandemic Outbreaks

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