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Editorial |

Implications of the Growing Use of Freestanding Children's Hospitals

Evan S. Fieldston, MD, MBA, MS; Steven M. Altschuler, MD
JAMA Pediatr. 2013;167(2):190-192. doi:10.1001/2013.jamapediatrics.126.
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In this issue of the journal, Berry et al1 present a longitudinal study documenting the growth in resource use of freestanding children's hospitals over 5 years. Using a system to classify patients by levels of chronic conditions, the authors report that hospitalizations increased by 18% to 32% for children with chronic conditions, most notably for those with complex lifelong chronic conditions. Freestanding children's hospitals play a unique role in caring for children, particularly those with special needs. While the study used data from half of the nation's freestanding children's hospitals, the results are likely representative of the experiences seen at all such institutions as well as at hospitals with large and comprehensive pediatric programs. Therefore, the implications for the future of pediatric health care and its reimbursement are profound.

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