Hospitals in the United States have closed pediatric intensive care units for critically ill children in Montana, Oregon and Missouri in the past year, and overnight pediatric wings have also closed in Illinois and California, CBS News reported Tuesday in a KFF Health News account¹.

Pediatric units, separate from neonatal intensive care, can serve patients from weeks old into their teens or early adulthood, depending on the hospital, the report said¹. CBS said many hospitals converting those beds to newborn or adult services have concentrated pediatric intensive care in medical hubs, so some critically ill children travel farther¹.

Elizabeth Mack, a pediatric critical care doctor and American Academy of Pediatrics spokesperson, said families cannot assume they will be fine if the next children's hospital is a flight or an eight-hour drive away¹. Hospitals cutting pediatric care tend to cite low volume because intensive care for children is relatively uncommon, CBS reported¹.

The report said the country is short of pediatric subspecialists, who typically earn less than physicians focused on adults, and that hospitals are often paid less to treat children than adults while pediatric equipment adds cost¹. CBS said cutbacks appear in rural areas and at community hospitals, whether small nonprofits or private-equity-owned systems¹.

A recent analysis cited by CBS found pediatric inpatient units fell nearly 30% from 2008 to 2022, from 1,749 hospitals to 1,226, leaving three-quarters of hospitals without pediatric inpatient services¹. Kenneth Michelson, lead author of that study and director of emergency medicine research at Lurie Children's Hospital of Chicago, said the number of hospitals performing appendectomies on children fell by more than half from 2003 to 2022¹.

CBS said medical researchers warn gaps could widen if federal Medicaid spending falls, because about half of U.S. children are covered by Medicaid or the Children's Health Insurance Program¹. The report said fewer Medicaid enrollments would hit hospital finances¹. Mack, who also consults on hospital quality, called cutting children's services a spreadsheet issue for most hospitals and said the work is expensive and hard to sustain¹.

In Missoula, Montana, Community Medical Center closed its pediatric intensive care unit this month, CBS reported¹. CEO Greg Cook said most children can still be treated there, but the sickest — for example those needing a ventilator — would be stabilized and transferred¹. Spokesperson Megan Condra later said the decision was driven by low volume and staffing, not concern about current quality¹. Cook said the hospital averaged about two intensive-care children a month and estimated the closure would affect about 25 patients a year, with the next in-state PICU about 150 miles north in Kalispell¹.

Cook said Community Medical Center, owned by for-profit Lifepoint Health, had not recruited a local pediatric critical care doctor since the last one retired eight years ago and had used fly-in rotations¹. St. Vincent Medical Center in Portland, Oregon, closed a four-bed pediatric ICU last November, citing too few patients, CBS said¹.

Raj Basu, division chief of critical care at Lurie Children's, said community hospitals that take complicated pediatric cases without enough experience can put patients at risk, and that doctors worry some children arrive sicker after longer transfers, though he said data do not yet prove that¹. Michelson said regional hubs can be overwhelmed in demand spikes, as in 2022 when children's hospitals were full¹. Proposed responses cited in the report include regional training and transfer protocols, more federal funding for low-access areas, and higher Medicaid reimbursement¹.

CBS News published the account with a KFF Health News credit¹. Independent hospital data and the Michelson paper were not reviewed for this filing beyond that report¹. Not medical advice.

Sources

1. CBS NewsHospital beds for the nation's sickest kids are disappearing5:00 AM

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