I was delighted to read your article on the booming subacute-care market (Dec. 13, 1993, p. 34). However, there's a facet of the story that's receiving far less coverage-the need to provide subacute care for children.
The need for such care has never been greater, largely because modern medicine is saving children who would have died a few short years ago. According to a 1990 survey by the National Association of Children's Hospitals and Related Institutions, hospitals discharged more than 148,000 children with one or more chronic or congenital conditions. Most of those-116,500-were discharged from a group of 35 children's hospitals.
Children who require subacute services include those with complications of premature birth, prenatal exposure to alcohol and drug abuse, congenital heart disease, and disorders involving genetics, orthopedics and the respiratory and central nervous systems.
So there's growing demand for the right kind of rehabilitative and specialized care, the kind that supports growth and development. Clinically, this means having a range of multidisciplinary services in place, complemented by the best, most up-to-date technology available. It also means tending to the educational, social and psychological development of the child, who may be out of the home environment for three to six months. And it means finding new and better ways to make the child's family an integral part of the care plan.
Subacute care for children is actually cost-effective-given the right children's facility, the cost of the service above might be as much as 70% less than that offered in an acute-care setting.
STUART C. KAPLAN
Executive vice president
St. Mary's Hospital for Children