Inpatient Pediatrics and Clinician Workforce in Wisconsin: The State of the State

Abstract

Introduction: Availability of inpatient pediatric services has declined across the United States between 2008-2018, with rural areas experiencing steepest declines. Despite the movement of pediatric care to children’s centers, most children are still cared for in community hospitals nationally. Assessing the availability and providers of inpatient pediatric care in Wisconsin is an important step in ensuring the health care needs of children in the state continue to be met. Methods: A cross-sectional survey was distributed to Wisconsin hospitals to determine pediatric services and physician workforce. Response rate was 130/138 (94%), including 56/58 (97%) of Critical Access Hospitals (CAHs). Results of specific inpatient pediatric subdivisions were analyzed by descriptive statistics. Results: Hospitals that provide inpatient newborn care are mostly staffed by pediatricians (P) and family physicians (FP), while CAHs are staffed by FP. Hospitals with neonatal intensive care units are staffed by neonatologists, with telemedicine utilized in CAHs. Hospitals with general pediatric admissions are staffed by P or FP, while CAHs are staffed by FP. Hospitals with pediatric intensive care units are staffed by pediatric intensivists. Conclusions: Despite workforce disparities and shortages, hospitals across Wisconsin, including many CAHs, continue to provide inpatient pediatric services. Family physicians play a major role in the pediatric healthcare delivery in Wisconsin hospitals. Robust inpatient pediatric training of family physicians may enable rural health authorities to continue addressing the gaps that persist in inpatient pediatric care accessibility.