[Pediatric intermediate care demand, results of a survey in 3 French regions].
In France, recent legislation for pediatric critical care organization endorsed the creation of a new level of pediatric care, the intermediate care units. These units treat children who require close monitoring and/or continuous monitoring due to potential failure of 1 or more organs, yet not to the degree of intensity of pediatric critical care. These rules do not provide precise admission and discharge guidelines for the pediatric patients requiring intermediate care. We conducted a questionnaire survey in all pediatric units in 3 French regions: Franche-Comté, Nord-Pas-de-Calais, and Rhône-Alpes. We obtained a response rate of 62.2% from the pediatric units. We estimated the pediatric intermediate care demand, with a unit occupancy rate of 80%, at 1.2 beds per 10 pediatric medical beds, 2.6 beds per 10 surgical beds, and 4 beds per 10 critical care unit beds or hemato-oncology beds. The intermediate care demand was higher in university-affiliated hospitals. One-third of the children referred to these units were less than 1 year old, 1/4 were less than 6 months old. We also described the diseases and potential organ failures of the patients who were referred to these intermediate care units. This study provides an estimate of the demand for pediatric intermediate care as defined in the French legislation and therefore helps implement projects to create such units. More specific criteria are still needed to oversee the implementation of these projects.
Service d'urgences, réanimation pédiatrique et néonatologie, hôpital Saint-Jacques, CHU de Besançon, 25000 Besançon, France. gerard.thiriez@univ-fcomte.fr
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D017677:Age Distribution; D001513:Beds / Q000706:statistics & numerical data; D002648:Child; D002654:Child Care / Q000592:standards*; D002675:Child, Preschool; D003422:Critical Care / Q000592:standards*; D003625:Data Collection; D005602:France; D006801:Humans; D007223:Infant; D007380:Intermediate Care Facilities / Q000592:standards*; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires