AMITA Health Saint Mary Hospital near Chicago’s Ukrainian Village neighborhood is looking to close its pediatric ward, the latest in a parade of hospitals in the region — and the country — to do so.
On an average day in 2019, St. Mary admitted only one child, and only 134 children for the entire year, according to an application AMITA filed with regulators in Illinois. AMITA, one of the largest health care systems in Illinois, has documented a steady decline in pediatric admissions over the years.
“After much thought and consideration, we believe our community will be better served in converting these needed beds into a general medical/surgical unit for inpatients,” said Bob Dahl, president and CEO of Saints Mary and Elizabeth Medical Center ( the two nearby hospitals are like one), wrote in a statement.
The majority of St. Mary’s patients are Latino or Black. More than a third of patients use Medicaid, the government’s health insurance program for low-income and disabled people, the latest state data shows.
The Illinois Health Facilities and Services Review Board, which regulates health care to avoid duplication of services, must approve AMITA’s request.
If approved, St. Mary will continue to treat children who enter the emergency room, but transfer them to other hospitals in the area if they need to be hospitalized. St. Mary will also continue to offer certain pediatric outpatient services.
Children’s beds are disappearing in the US
St. Mary’s proposal illustrates a trend that has been going on across the country for years. dr. Matthew Davis, the chief pediatrician at Lurie Children’s Hospital, a regional destination in downtown Streeterville for the sickest children, explains what causes this.
First, more children are being vaccinated against flu and pneumonia, which meant that more children had to go to hospital in the past. More doctors are adding to the types of vaccines they give children, such as those that have helped reduce the number of children hospitalized for diarrhea and dehydration.
And doctors are doing a better job of treating children with chronic medical conditions like diabetes and asthma. That keeps flare-ups at bay that could have meant hospital time in the past.
As a result, many community hospitals are seeing fewer children requiring hospitalization and are therefore phasing out their pediatric wards to treat more adults instead.
Despite the new reality, Davis calls the shift worrying. He studies the trend locally and its impact.
“What we wanted to understand are the circumstances that drive hospitals to make this decision, which affects the families’ access to hospital-level care for their children near where they live,” Davis said. “It’s a challenging balance to strike because we know it’s very difficult to maintain high-quality, safe inpatient care for children in very low-volume hospitals. But we also want to try to optimize it for parents.”
In 2019, hospitals across Illinois used just over 1,000 pediatric beds at their busiest times, according to the most recent state data. That year there were 31,325 pediatric admissions.
Four years earlier, there were 155 extra beds available for children and nearly 12,000 more pediatric hospital admissions.
While there has been an overall decline in the number of children admitted to hospital, some of the larger hospitals that typically treat many children are still just as busy, or getting busier. Community hospitals bring and refer children to those larger hospitals, Davis said.
At Lurie, that meant adding about 25% more hospital beds since the medical center opened nearly a decade ago. There are now about 360 beds in the tower in downtown Lurie.
“We quickly realized this wasn’t enough to meet the needs of Chicagoland and beyond,” Davis said.
Almost all extra beds are in the intensive care unit.
What this means for parents and their children
In general, it’s unusual for children to be hospitalized, said Dr. Edward Pont, chairman of government affairs for the Illinois division of the American Academy of Pediatrics and a local pediatrician.
But as community hospitals phase out pediatric care, barriers can arise for parents and their children. Traveling onward to another hospital can be cumbersome and expensive – think an expensive parking garage in the city center – and scary at a time when parents and their children are particularly vulnerable.
“You take a parent through one of their most vulnerable moments, where you say to them, ‘Your child is so vulnerable they need to go to the hospital now. Your care will be with another doctor,” Pont said. “I’ve yet to find the least bad way to let a parent know.”
But he stressed that sending children to a hospital with doctors who specialize in pediatrics is the best care.
“The way you provide quality assurance and the way you avoid mistakes is by doing the care over and over again,” Pont said.
Davis underlined another need: that all hospitals are still willing to treat sick or injured children when they come to the emergency room, regardless of whether the hospitals are still taking the youngest patients.
Kristen Schorsch covers public health at the WBEZ government and politics desk. Follow her @kkortch.