"maria sklodowska curie" children s hospital

Transcription

1 "maria sklodowska curie" children s hospital

2 The total number of beds in Romanian Hospitals has been gradually decreasing, with 6.5 beds per 1000 people in Out of the hospital beds in Romania, xxx are pediatric beds. According to international standards, Romania should have 200 pediatric beds per 1 million people, corresponding to approximately 4000 pediatric beds. Furthermore, Romania has no Pediatric Regional Emergency Hospitals. The M.S. Curie Hospital has 530 beds. Although it is the largest pediatric hospital in the country, it does not have the technical capacity to ensure medical aid to the entire pediatric pathology. 1

3 1 P E D I AT R I C C A R D I O L O G Y A N D C A R D I A C S U R G E R Y The Pediatric Cardiac Surgery center at M.S. Curie was founded in 2013 and has been continually growing. The average age of the patients has been rapidly decreasing from 6.63 years in 2013 to 2 years in 2016, corresponding to more complicated cases and hence a higher DRG casemix coefficient. The number of cases treated is rising. Currently, the Cardiac Surgery department is functioning with the help of teams from abroad, which perform surgeries for days per month. The hospital has signed a contract with the San Donato Policlinic in Milan, based on which they perform 100 surgeries and 100 cardiac catheterizations. Given the new facilities, the team could double the number of procedures they perform. In order to work efficiently, a Pediatric Cardiac Surgery Center should operate a minimum of 250 children yearly, out of which 100 newborns. The new hospital should treat at least 400 patients per year. In order to do so, the following facilities are needed: 1 cardiac catheterization room 2 operating theatres 1 Cardiac ICU with 14 beds 1 Cardiology section with 25 beds 1 imaging centre with the following equipment: 1 cardiac CT, 1 cardiac MRI, 1 cardiac scintigraphy equipment A minimum of 2 rooms for echocardiography 2

4 2 P E D I AT R I C T R A U M A C E N T E R Romania has no trauma center for children. The pediatric trauma cases are treated in adult hospitals, without having a complementary pediatric medical aid. The reason is the poor development of the pediatric subspecialties, compared to adult medicine specialties. In addition, there are pediatric hospitals with a bed surplus which are used for simple cases, which leads to the inability to absorb the appropriate cases. The M.S. Curie hospital comprises a multidisciplinary array of doctors, an emergency unit already integrated in its structure and a good position in Bucharest. In addition, it is already a renowned center with nation-wide coverage. These reasons justify the development of a pediatric trauma center within the hospital. Emergency care Operating theatres (at least: neurosurgery, orthopedics, general surgery) Anesthesiology General pediatric surgery Orthopedic surgery Neurosurgery ENT Pediatric ophthalmologic surgery Pediatric ICU (general and neurosurgical) NICU General Pediatrics Infectious Diseases Pediatric Cardiology Pediatric Gastroenterology 3

5 pediatric trauma center 4 Pediatric nephrology. Hemodialysis Pediatric neurology Pediatric Imaging Centre (with at least: 2 CT, 2 MRI, 4 Doppler Machines, 4 Radiology Machines) Interventional radiology Transfusion center Recovery center Pathological anatomy Social care Psychological care Heliport

6 3 P E D I AT R I C I N T E N S I V E C A R E In Bucharest, the required number of beds for pediatric intensive care is approximately According to our statistics, there are currently approximately 70 ICU beds. The poor development of this segment of pediatric care is reflected in the statistics of annual deaths at national level (2014). The pediatric mortality rate is double the European average. The main causes are respiratory ailments, intoxications and trauma. This statistic is not recorded: Deaths from respiratory ailments over 1000 cases annually Deaths from trauma over 500 cases annually In order to be able to treat severe respiratory diseases, traumas, severe infectious diseases and complicated surgical pathology, M.S. Curie needs the following structures: PICU 18 beds Post-operator ICU 20 beds Guest house parents 5

7 4 N E O N ATA L I N T E N S I V E C A R E According to current statistics, Romania has the capacity to provide medical services for 54% of the newborns with severe ailments. Currently, the country has: 22 level III maternities, which have 230 beds 41 level II maternities, which have 220 beds 2 hospitals with 40 level III resuscitation beds 5 pediatric hospitals with 50 level II resuscitation beds The national requirements are for 500 level III beds, corresponding to beds/1m population or 6-8 beds/1000 newborns. Therefore, Romania has the capacity to treat only half of the newborns with critical diseases. The NICU at M.S. Curie is the largest in Romania, with a mortality rate 3 times lower than the national average. Currently, the care pathology is the most complex in the country. The ICU center is permanently full, with an occupancy rate of around 80%, calculated using 27 beds (not all of which are functional). The casemix coefficient for the ICU is around 6, proving the complexity of the cases treated. In order to decrease costs for patient transportation from over 150km, next to the ICU, there needs to be an obstetric section for neonatal cases with major risk, which should benefit from fast and intensive surgical interventions. There is no such facility in Romania. Because most newborns from other regions are transported by helicopter, it is necessary to build a heliport. At least 300 patients from outside of Bucharest should be transported by helicopter. In order to treat patients annually, the hospital needs the following: NICU 35 level III beds NICU special care (post intensive care) 18 beds Obstetric for risky birth 15 beds, 1 sudden birth room, 1 c-section room, ICU post-operator obstetrics -4 beds Neonatal surgery block 1 roo Heliport Milk bank 6

8 5 H E M ATO L O G Y A N D P E D I AT R I C O N C O L O G Y Currently, it is possible to treat over 70% of pediatric oncology cases. Certain tumors can be cured completely. A good rate of survival can be reached only with multidisciplinary teams of specialists in pediatric hospitals. The national network of hematology and pediatric oncology lacks the necessary infrastructure. As a result, xxx patients choose to get treatment abroad. Bucharest has four centers that offer pediatric oncological and hematologic treatment: IOB Fundeni Grigore Alexandrescu M.S. Curie IOB and Fundeni are adult hospitals, where children do not benefit from the auxiliary pediatric care they require. Grigore Alexandrescu could theoretically absorb some of the cases from the adult hospitals. However, the oncology ward there is small and unable to accommodate more cases. Given these considerations, M.S. Curie could absorb up to 500 cases from adult hospitals. In order for the center at M.S. Curie to function according to European Standards, it needs the following: Bone marrow transplant Oncology ward General pediatrics Hematology with day care Oncology Daily chemotherapy chairs Pediatric anesthesiology Pediatric ICU Radiotherapy center Transfusion center Nuclear medicine (PET CT - Positron Emission Technology), PET IRM, gamma room Polyclinic Educational center for hospitalized children Guesthouse for parents 7