Children are dying in US hospitals plagued with ill-prepared ERs: WSJ
Doctors, health authorities, and policymakers have known of these failures and warned against them for decades.
Every year, numerous children either lose their lives or sustain serious injuries across the US due to being brought to hospital emergency departments that are ill-equipped to provide them with adequate care.
The Wall Street Journal's investigation revealed that approximately only 14% of emergency departments across the country have received certification for their readiness to care for children, or are specialized children's hospitals dedicated to treating young patients.
A significant number of emergency physicians lack the experience of treating a sufficient number of children, making it challenging for them to identify life-threatening illnesses that might have symptoms resembling more common, everyday health issues or conditions primarily found in pediatric cases, as per the WSJ.
In some cases, emergency room staff resort to using drug doses and treatment protocols designed for adults, and they may either lack access to or are unaware of the whereabouts of appropriately sized medical equipment for children in emergency situations.
For decades, healthcare professionals, public health authorities, and policymakers have been aware of these shortcomings and have issued warnings against them to no avail. Recent research has provided concrete data on the inadequacy of preparedness and the avoidable child fatalities, while also highlighting fundamental measures to address and resolve this issue.
In further detail, The Wall Street Journal's inquiry into certification levels across all 50 states and Washington, D.C., scrutiny of medical records, and discussions with physicians, health experts, and researchers revealed that the majority of hospitals have not taken corrective measures.
In many areas, parents lack the necessary information to make informed decisions about which hospital to choose for their child in a medical emergency. Although over 70% of emergency departments have undergone a federally funded assessment to determine their readiness for pediatric cases, individual hospital results remain confidential. Furthermore, 25 states do not assess the pediatric preparedness of their emergency rooms at all, and even those that do often do not disclose the names of hospitals that have achieved recognition for their preparedness.
An age-old problem
As early as 1984, following a situation where a child of a US Senate staff member received subpar care in an emergency room, Congress initiated the allocation of funding to address these deficiencies. Subsequently, professional medical organizations, such as the American Academy of Pediatrics, the American College of Emergency Physicians, and the National Academy of Medicine (formerly known as the Institute of Medicine) have released reports expressing concern about the state of emergency care for children.
Hospitals have not been strongly motivated to enhance child care because several government agencies and professional organizations have not made it a mandatory requirement. State-level initiatives aimed at assisting hospitals in this regard have faced financial constraints, with limited federal funding available. Additionally, child emergency care does not generate as much demand or revenue as other healthcare services.
The federal funding allocated to states for the improvement of child emergency care stands at approximately $190,000 per state annually. This sum is sufficient to cover the cost of only one or two staff members and provide some training for hospitals and emergency responders, according to statements from state program officials.
Hospitals primarily generate a higher income from adult patients, given that they serve a larger number of elderly individuals. In contrast, the treatment of children, especially those covered by Medicaid, often results in financial losses for hospitals, as the reimbursements from Medicaid do not adequately cover all associated expenses. It's worth noting that the majority of safety standards, as established by the Centers for Medicare and Medicaid Services (CMS), the primary regulatory body for hospitals in the United States, and the Joint Commission, a private organization responsible for setting hospital standards, are generally designed to apply to individuals of all age groups rather than being specifically tailored to the unique needs of children.