A study of Northwest Indiana hospitals shows a gaping hole in care for critically ill children.
None offers a pediatric intensive care unit, which means children who are severely injured or suffering from serious illness are sent to Chicago-area hospitals, Indianapolis or South Bend.
Samuel Flint, associate director of Indiana University Northwest's School of Public and Environmental Affairs, along with graduate students Fred Buckley and Catherine Spann, presented findings in October about unmet trauma and pediatric intensive care needs in Northwest Indiana.
"Failing to have a PICU (Pediatric Intensive Care Unit) or an EMS-C (Emergency Medical Services for Children) in a community of nearly 1 million is another risk of life and limb to children that civilized communities should not have to tolerate," the report states.
It comes down to money.
Franciscan St. Margaret Health hospital in Hammond had a PICU from 1995 to 2004.
"It closed because, although it was very busy, reimbursement was poor, so we were unable to build a full complement of pediatric specialists and subspecialists around it to support the wide-ranging needs of the pediatric population served by it," said Gene Diamond, CEO of Franciscan Alliance’s Northern Indiana Region.
"The pediatric population is disproportionately Medicaid funded. The difference between our costs and what Indiana and Illinois reimbursed us under their respective Medicaid programs caused the PICU to succumb,” he said.
The hospital system may bring a pediatric intensive care unit back to northern Indiana.
"The Northern Region of Franciscan Alliance is considering the development of a PICU, but no firm decisions have been made regarding timing or location," Diamond said.
For now, the go-to centers are in Chicago and its suburbs, South Bend or Indianapolis.
"If there's a kid who needs intensive care or more one-on-one care, all of these kids have to be transferred out," pediatrician Dr. Chantal Walker said.
Aside from the health toll a long transfer can have on a sick child, traveling out of the area for care means time away from work and household duties.
There is added expense for gas, food and lodging. Riley Hospital for Children in Indianapolis has a Ronald McDonald House, where guardians of sick children can stay, but it is not always available, Walker said.
Walker, a volunteer faculty member of the IU School of Medicine-Northwest, said there's a definite need for a local pediatric intensive care unit. Local hospitals may have pediatric floors or units, but they are not prepared to take on the most critically ill children.
Walker's husband, Dr. Roland Walker, also a pediatrician, is the health commissioner for the city of Gary. He said there is support for a local PICU.
"It probably won't come together overnight, but it is needed overnight," he said.
The difficulty is not in building a PICU, Dr. Roland Walker said. It's in staffing one, attracting pediatric specialists to work there
As expensive as it would be to operate a PICU, it would keep the money in Northwest Indiana.
"From an economic standpoint, we are sending so much money out and putting a burden on families," Dr. Roland Walker said.
Gary is an ideal location, with IUN's medical school possibly serving as a training ground for pediatric specialists, he said.
"I think more people need to be advocates for children," he said. "It takes people to keep beating the drum over and over."