Pediatric Inpatient Services Listings.

[RustedFox]

Hey all,

EM attending here, asking if there's an easy way to look-up which hospitals do/do not have inpatient peds services online.
Best buddy back home in RURAL central PA has a two year old girl, and made the critical mistake during a recent ER visit of presuming that "because the ER doc saw her; that they could just take care of her there overnight". Thus, we had to have a tough talk, where he learned the lesson of "KNOW your nearest pediatric hospital".

Hospital websites can be a bit misleading; I've run into at least two now that list "pediatric services"; but I know for a fact that they're just listing the adjacent outpatient peds offices.

Thanks in advance.

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[SurfingDoctor]

Hey all,

EM attending here, asking if there's an easy way to look-up which hospitals do/do not have inpatient peds services online.
Best buddy back home in RURAL central PA has a two year old girl, and made the critical mistake during a recent ER visit of presuming that "because the ER doc saw her; that they could just take care of her there overnight". Thus, we had to have a tough talk, where he learned the lesson of "KNOW your nearest pediatric hospital".

Hospital websites can be a bit misleading; I've run into at least two now that list "pediatric services"; but I know for a fact that they're just listing the adjacent outpatient peds offices.

Thanks in advance.

I don't know if its easy to find honestly... but I do think rural hospitals are reasonable at triaging. I think most of them realize short of a couple liters of oxygen or IV fluids, they are way over their head and are usually pretty good about transferring. If they aren't, I suspect the local referral hospital's outreach is the bigger problem.

One way to know though is if they are part of a healthcare alliance network. If so, then they usually have built in referral patterns. We get a fair number of our inpatient transfers from rural hospitals that are part of the network.

 

[RustedFox]

I don't know if its easy to find honestly... but I do think rural hospitals are reasonable at triaging. I think most of them realize short of a couple liters of oxygen or IV fluids, they are way over their head and are usually pretty good about transferring. If they aren't, I suspect the local referral hospital's outreach is the bigger problem.

One way to know though is if they are part of a healthcare alliance network. If so, then they usually have built in referral patterns. We get a fair number of our inpatient transfers from rural hospitals that are part of the network.

Thanks.
Reason I ask is that its time for BestBuddy to switch health insurance plans (new job) and his recent ER visit for the kiddo made him "sit up and pay attention". He's in Mayport, PA (turbo-rural), so obviously Pittsburgh is the regional mecca, but he'd rather not have to drive all that way if say, Punxsutawney or Indiana, PA had inpatient peds (they don't)

 

[SurfingDoctor]

Thanks.
Reason I ask is that its time for BestBuddy to switch health insurance plans (new job) and his recent ER visit for the kiddo made him "sit up and pay attention". He's in Mayport, PA (turbo-rural), so obviously Pittsburgh is the regional mecca, but he'd rather not have to drive all that way if say, Punxsutawney or Indiana, PA had inpatient peds (they don't)

Yeah, unfortunately there not much he can do about that. Most rural hospitals don't have the medical expertise and since pediatric reimbursements are typically low, there's little financial incentive to develop it. Fortunately though, Pittsburgh has a good emergency transport system should the need arise. We often transport children who need our services 4 hours driving distance or further.

 

[mvenus929]

I mean, my hospital takes people from 8 hours away. There aren't really any inpatient services for pediatrics outside of two cities in the state, unless they're older adolescents who just need something simple (appy, oxygen, IV fluids). We pretty routinely get transfers from 1-3 hours away.

 

[RustedFox]

I mean, my hospital takes people from 8 hours away. There aren't really any inpatient services for pediatrics outside of two cities in the state, unless they're older adolescents who just need something simple (appy, oxygen, IV fluids). We pretty routinely get transfers from 1-3 hours away.

I getcha; but it seems downright silly to transfer a patient 3 hours for an appy. West PA is mountainous, but not "Kansas-Style" sparsely populated.

 

[PTPoeny]

I getcha; but it seems downright silly to transfer a patient 3 hours for an appy. West PA is mountainous, but not "Kansas-Style" sparsely populated.

Some of those places listing pediatric services will allow general pediatricians to admit their own patients. But that won't help your friend if their pediatrician doesn't do that. But yeah, anything much at all is getting transferred and your friend's pediatrician and local ED docs are going to be the best information for where the closest peds floors are located.

It is actually worse in the northern half of the state. ‍♀️

 

[RustedFox]

Some of those places listing pediatric services will allow general pediatricians to admit their own patients. But that won't help your friend if their pediatrician doesn't do that. But yeah, anything much at all is getting transferred and your friend's pediatrician and local ED docs are going to be the best information for where the closest peds floors are located.

It is actually worse in the northern half of the state. ‍♀

Northern PA?

Oh, you mean "here be dragons".

 

[WheezyBaby]

I don't know of any such reference online. Best to just look at local hospitals' websites and call to confirm. Even community places that do have a peds unit take care of a relatively restricted range of pathology though in my experience. As far as an appy, if the kid is young a 2-3 hour transport is not at all out of the ordinary. If they're 15, sure, let the local adult gen surg operate. But you're not going to have ready access to ped surgery outside of a metropolitan area

 

[Sushirolls]

I once took my kid to a peds specific hospital. Was seen by an ARNP.

So the more meaningful question, is does it really matter where you go when the end result of ED care is that you get seen by an ARNP?

 

[SurfingDoctor]

I once took my kid to a peds specific hospital. Was seen by an ARNP.

So the more meaningful question, is does it really matter where you go when the end result of ED care is that you get seen by an ARNP?

Depends on what the reason you are taking a kid to an ED? Would you rather have the ED physician treating the level 1 trauma victim, or swabbing throats to confirm viral pharyngitis?

Since the initial comment was in relation to an appendicitis, the NP association is irrelevant.