Abstract

Community-wide planning of hospitals and related facilities in a metropolitan area helps to translate the miracles of modern medical science into high quality service for all at reasonable cost. Community-wide planning for children's inpatient services should encourage grouping of small segregated pediatric units in which most children receive care today. These small units interfere with provision of high quality, comprehensive care and are wasteful of scarce personnel and dollars. Experts should agree upon the minimum size unit in which effective care can be provided; this minimum would obviously be much larger than most units in existence today. To achieve this minimum, most general hospitals should affiliate with major general hospitals or children's medical centers at which their pediatric inpatient facilities could be grouped into a few large units. The children's medical centers should take leadership in exploring the feasibility and nature of such affiliations of which the key element is the medical staff relationship. Such affiliations are consistent with and conducive to valid objectives of children's medical centers: leadership in promotion of child health, child care, education and research. Failure of children's medical centers to develop such affiliations may have dire consequences in the long run.

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