There's no question that Lurie is bursting at the seams. In 2016, the hospital denied 112 transport requests to receive critically ill kids because it didn't have enough beds available, according to Stephenson. Comer and Advocate report the same. "We will have to turn away hundreds of patients this year from our South Campus (in Oak Lawn) due to lack of space," says Matt Robbins, Advocate Children's Hospital's chief strategy officer.
Why Chicago's Lurie is expanding when smaller hospitals are turning away from pediatrics
As the gleam of these mega-hospitals intensifies, smaller hospitals' prospects flounder. Lurie's expansion, which will add 44 intensive care beds and four neonatal intensive care beds to increase the total to 336, comes as 15 area hospitals have reduced or closed pediatric inpatient facilities since 2013.
"This is a broad phenomenon: Small hospitals are having a hard time because they don't have the clout to negotiate high rates, so some are falling by the wayside," says Paul Ginsburg, director of the Center for Health Policy jointly run by the Brookings Institution and the University of Southern California. The result for the consumer, he warns, could be increased costs. "When hospitals don't face competition, it substantially reduces the pressure to operate efficiently."
Two decades ago, a child who suffered a severe asthma attack would likely wind up in his local community hospital for a night or two, explains Dr. John Cunningham, chair of pediatrics at University of Chicago. These days, those less-critical cases are handled at outpatient centers and through preventive initiatives such as U of C's new South Side asthma center. And while smaller children's hospitals always shuttled their sickest kids to specialty hospitals, these days, without the less-acute cases to fill their beds, some pediatric wards are empty. From a smaller hospital's point of view, why not convert that space to meet demand for adult inpatient care as aging baby boomers suffer strokes and heart attacks?
The smaller hospitals have struggled, too, to compete with bigger, fancier rivals. Lurie commands 28 percent of the pediatric market share in the Chicago area, according to the most recent numbers available from Fitch Ratings; in 2003, it had 12 percent.
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