US Pediatric Care in Sorry State Amid Upsurge in Youth Mortality Rate
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Despite being one of the wealthiest and most developed countries in the world, the United States has witnessed a serious uptick in child and adolescent mortality of late.
A new study has concluded that mortality rates among children and teenagers in the United States increased by about 20 percent between 2019 and 2021.
Homicide, suicide, drug overdoses and car accidents were identified as primary reasons for this upsurge among Americans aged between 10 and 19. The study authors also pointed out that COVID-19 “contributed little” to this trend.
The study was carried out by doctors affiliated to the Virginia Commonwealth University and the University of Washington.
In this context, Dr. Yolanda Hancock, a board-certified pediatrician and public health expert who was not involved in the study, told Sputnik that the worrying situation is exacerbated by an apparent lack of proper pediatric care in the United States.
“I always tell people children aren't simply little adults. They're completely different. The disease processes that they present with are different. Their symptoms are often different,” Hancock explained during an interview with Sputnik. “The equipment that's needed to take care of them is different. And clearly the training that one requires to be able to provide effective care is also different.”
According to her, the current state of affairs in US pediatrics formed thanks to several factors, one of them being the difference in healthcare reimbursement rates for children and adults.
“Even though a child may have an asthma attack and an adult has an asthma attack, an emergency room is going to get more money for the adults simply because of the way that the system is set up. It doesn't mean that there's less care provided to the child. It's simply an issue of reimbursement. Hospitals get way more money. Way more revenue is generated from adults,” Hancock said.
She recalled how, “during and after the COVID,” pediatric emergency rooms and hospital wards were being completely shut down because, aside from the “need for space” during the pandemic, some hospitals realized that they “get more money by bringing more adults in who are sicker” and deemed it more profitable to “focus on adults” rather than “bring pediatric care back in.”
22 August 2023, 02:46 GMT
Hancock also pointed out that pediatric care requires specialists with proper training able to recognize “pediatric issues” and know how to treat them, and proper equipment such as, for example, the “appropriately sized breathing tubes and masks” to intubate a child.
Last but not least, Hancock noted, is the fact that “many pediatric hospitals are being shut down and standalone hospitals aren't offering pediatric inpatient services, there's no place for children to be transferred once they are stabilized in an emergency department.”
“As I learned when I used to work in the emergency department, the goal is to ‘treat and street’, meaning ‘take care of them and get them out on the street so that we can see the next patient.’ And if you have pediatric patients that you cannot transfer out, that means more beds being held up and fewer patients that you can see. So all of those things are working together to facilitate our children dying because they don't have access to emergency care.”
From the public health policy point of view, Hancock argued that children in the United States are neither valued nor prioritized.
She insisted that the US federal government, which “provides the coverage for children who are under-insured or not insured” through Medicaid - a program that provides health insurance for Americans with limited income – should improve the reimbursement rates for children, “because the majority of children who end up showing up in the department usually are insured by Medicaid.”
Furthermore, Hancock added, every emergency department and hospital that provides emergency services and receives “federal dollars” should be required to have both the staff “trained to navigate through pediatric emergencies” and the equipment to deal with such emergencies.
