[Neonatal and pediatric intensive care in Rio de Janeiro: distribution of beds and analysis of equity].
OBJECTIVE
To identify the pediatric ICUs at Rio de Janeiro, number of beds, geographical distribution, public or private nature, type of hospital and assistance, studying population demand and to propose measures for improving equity.


METHODS
All ICUs of the State were visited from July 97 to June 98, identifying number of beds and average length of stay. With this information along with demographic data from IBGE, the necessity of beds were estimated, comparing availability and demand by region, and proposing improving equity strategies.


RESULTS
80 ICUs were identified (6 excluded), totaling 1080 beds; 60% intensive and 40% semi-intensive; 57% public and 43% private; 52% in exclusive neonatal ICUs; 14% in pediatric and 34% in mixed (65% neonatal beds), totaling 791 neonatal beds (73%). The majority of ICUs (75%) were part of general hospitals, 20% were in obstetric or obstetric-pediatric hospitals, and only 5% were part of university centers; the majority were in metropolitan area (89%), with 93% of beds for 74% of state children population, of whom, the majority were in Rio de Janeiro city (76%), with 73% of beds for 37% of population, contrasting with the inner of the State, with only 8 units (11%) and 79 beds (7%) for 26% of children.


CONCLUSIONS
There is no equity in the distribution and accessibility to the available beds, with lack in public and excess in private sectors, a great concentration in the metropolitan area and only 5% of ICUs at university hospitals, recommending a policy of redistribution and allocation of new beds in more needy areas, associated with the creation of an admission center along with an efficient reference and transportation system.
Barbosa
Arnaldo Prata
AP
Instituto de Puericultura e Pediatria Martagão Gesteira, da UFRJ - Rio de Janeiro, RJ, Brasil.
da Cunha
Antônio José Ledo Alves
AJ
de Carvalho
Edimilson Ramos Migowski
ER
Portella
Andréa Ferreira
AF
de Andrade
Miriam Perez Figueiredo
MP
Barbosa
Maria Clara de Magalháes
MC
D000293:Adolescent; D001509:Bed Occupancy / Q000706:statistics & numerical data; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D006297:Health Services Accessibility; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data / Q000600:supply & distribution*; D015931:Intensive Care, Neonatal / Q000592:standards*; D010343:Patient Admission / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000592:standards