title: [The necessity for centralization of pediatric intensive care].
abstract: Substantial evidence indicates that outcome of critically ill children, treated in tertiary paediatric intensive care units (PICUs) is superior to that of those treated in other settings. However, a significant number of children who require this level of care are not admitted to such a unit e.g. due to capacity constraints, reluctance of physicians of general hospitals to refer children to a tertiary centre, and transportation problems. Centralization of care, as recently proposed in the UK, is necessary in the Netherlands, as well, to improve the quality of care. This will require a controlled number of PICU beds in a restricted number of centres, adequate transport facilities and step-down or high dependency units in large general hospitals.
authors.affiliation: Afd. Kindergeneeskunde, Wilhelmina Kinderziekenhuis-Academisch Ziekenhuis Utrecht.
authors.forename: R J
authors.initials: RJ
authors.lastname: Gemke
authors.forename: E
authors.initials: E
authors.lastname: van der Voort
authors.forename: A P
authors.initials: AP
authors.lastname: Bos
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000458:organization & administration* / Q000592:standards; D006742:Hospital Bed Capacity; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000458:organization & administration*; D009426:Netherlands; D011787:Quality of Health Care; D012017:Referral and Consultation; D014187:Transportation of Patients