Questions and Answers about Contra Costa Health Services for Children

Is it true that Contra Costa Regional Medical Center (CCRMC) is no longer accepting inpatient admissions for children under 18 years old?

Starting April 15, 2008, CCRMC will no longer accept pediatric inpatient admissions. We will continue to evaluate the impact of closing the pediatric inpatient department on our pediatric patients, CCRMC and the community.

What arrangements will be made for children who need to be hospitalized?

Arrangements are being put in place now with Children's Medical Center in Oakland and American Medical Response, our ambulance service, to transfer any children who come to the CCRMC Emergency Department or to our Health Centers and need to be hospitalized.

Why is Health Services planning to close its inpatient pediatric unit?

Contra Costa Health Services (CCHS), the county health department, has decided that operating an inpatient pediatric unit (for very sick children under 18 years old) is not the best way to deliver quality care. The average daily census - the number of patients in beds - for the Pediatric Department for the past few years has been fewer than 1.5 children a day - fewer than 300 children admitted in an entire year.

Is this unique to Contra Costa County?

Pediatric care has changed dramatically in the past decades and the closing of pediatric units in small hospitals like CCRMC has been a trend across the country.

Why has pediatric care changed?

There are a number of reasons for this shift.

Years ago, before there were vaccines for childhood diseases like mumps, measles, chicken pox and polio, more youngsters got seriously ill. They were hospitalized regularly, often for long periods of time. Their family doctor visited them - usually in a small, local hospital.
Before penicillin and other more recent antibiotic drugs, admission to a hospital was often the only treatment for sick children. Pediatric departments in hospitals were busy places in those days.
Happily today, many fewer children have to be admitted to medical facilities. They can be seen in doctors' offices and treated at home.

How are really sick children treated now?

For really sick kids, the new strategy is to have very specialized, high technology medical centers - called tertiary care facilities - provide treatment. This approach means that sick children can receive the highest quality care from health professionals with the best equipment and the most experience. The vast majority of doctors who see those children are specialty pediatricians who spend much of their time in hospitals rather than in a primary care setting.

In Contra Costa, Children's Hospital in Oakland is that tertiary care facility for our seriously ill young patients. There were more than 4,000 pediatric admissions for Bay Area youngsters in 2006 at Children's - about four times the number in all the hospitals in our county combined.

To provide high quality care to very sick children, the facility must be able to have an entire range of pediatric services available at all times. When there are small numbers of patients, it is a major challenge to maintain competency and utilize nursing and other resources in the best possible way.

Will Health Services continue to provide some care to children?

Absolutely. Here are some examples of services we provide to children in Contra Costa:

The Medical Center delivers more than 200 babies a month. It will be possible now to shift resources from the underutilized Pediatric Department to Labor and Delivery and the Nursery at CCRMC.
Our Health Centers - which provided 24,737 out-patient pediatric visits in the first 10 months of 2007 - will continue to serve children under 18 with well baby visits, primary care, childhood immunizations and other services.
We have many programs that address important issues related to children's health including Lead Poisoning Prevention, Childhood Obesity and Mental Health services. Our Maternal and Child Health Program provides a broad array of services from children oral health, Women, Infants and Children supplement nutrition program, Black Infant Health program, the TeenAge program and more.

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