'Policy determines pediatric survival, worsening inequality'

Pediatric hospitals have stressed the need to expand the Pediatric Regional Cooperation Network pilot project.

Participation in the project has greatly improved advanced hospitals’ ability to accept critically ill pediatric patients transferred from smaller facilities. Seven out of 10 pediatric hospitals that are not participating in the pilot project have difficulty transferring patients, while nine out of 10 participating hospitals can find transferrable hospitals.

The Korea Children’s Hospital Association (KCHA) revealed the results of a survey on patient transfers by pediatric and adolescent hospitals at a news conference and called for countermeasures on Monday.

The association emphasized that the network should be reorganized based on treatment areas rather than administrative districts to better support the pilot project.

The survey was conducted from May 1 to 16, including 20 directors from hospitals participating in the pediatric regional cooperation pilot project and 202 salaried physicians from non-participating hospitals. Only 20 pediatric hospitals designated by the Ministry of Health and Welfare are participating in the pilot project.

Among the staff of pediatric hospitals not participating in the pilot project, 18 percent said that tertiary hospitals “rarely accept” referrals of critically ill pediatric patients transferred by pediatric hospitals, and 43 percent said that the tertiary hospitals “intermittently accept” them, for a total of 61 percent. In contrast, those who replied that tertiary hospitals “always accepted” and “usually accepted” transferred patients accounted for 1 percent and 38 percent of respondents.

In the pediatric hospitals participating in the pilot, 15 percent of those surveyed said their transferred patients were “always accepted,” and 75 percent said they were “usually accepted,” for a total of 90 percent. Only 5 percent of the respondents said they were “intermittently accepted” and “rarely accepted.”

“The fact that all hospitals participating in the pediatric care regional cooperation system pilot project had a virtually 100 percent acceptance rate, while 61 percent of non-participating hospitals reported that they were unable to accept children, shows that there is .a structural inequality where a child’s survival may depend on whether their hospital is part of the pilot project,” KCHA President Choi Yong-jae said.

“The survey was able to gauge the impact of the pilot project on all pediatric hospitals in the country,” Choi said. “However, its limitations stem from being based on administrative districts, which do not reflect the actual treatment needs of patients. A holistic review of the policy direction is needed.”

Choi emphasized that to utilize the positive effects of (the pilot project) in the future, it needs to be redesigned into a regional cooperation network based on medical service areas.

“The support for trainee doctors wanting to specialize in pediatrics has long since been cut off. The remaining doctors in the field are aging, and a pediatric medical workforce gap is emerging,” Choi said in his appeal to presidential candidates. “Please set up a system to encourage young doctors to apply to pediatrics. We must also prepare mid- to long-term measures for pediatric medical care at the national level, including securing a foundation for continuing pediatric care.”