California hospitals between 1998 and 2007 eliminated 19%, or more than 800, inpatient pediatric beds, according to a Los Angeles Times analysis. The analysis found that more than 65 hospitals in California have cut their children's units or closed altogether, and more than 24 other hospitals have scaled back the number of beds that they allocate specifically to pediatric inpatient services. More than half of the eliminations have been in Los Angeles County.

The situation has resulted in pediatric services increasingly being consolidated in California's eight regional children's hospitals. According to the Times, most counties north of Sacramento County do not have any hospital beds dedicated to pediatric patients. The analysis did not consider intensive care beds for children and infants. Currently, California has about one licensed pediatric bed per 2,500 children. The Times reports that many hospitals have eliminated pediatric beds to focus more on services for adults, who receive greater federal and state subsidies. Diana Dooley, CEO of the California Children's Hospital Association, said the situation is exacerbated by low Medi-Cal reimbursement rates for children's health care, which she says are the lowest in the nation. Medi-Cal is California's Medicaid program.

The cutbacks in pediatric beds have proceeded "without serious, coordinated analysis of how the losses statewide could affect the quality of care," especially as some areas are expected to see jumps in population, the Times reports. University of California-Los Angeles researcher Dylan Roby said it is unclear how many pediatric beds are needed in California because the issue has not been studied adequately. In the next few months, researchers at the UCLA Center for Health Policy Research are expected to release a report that finds that staffed pediatric beds are not keeping up with the pace of the population (Yoshino, Los Angeles Times, 1/25).

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