The Adobe Flash Player is required to view this multimedia interactive. Get it here.

Competition bad for ill newborns, research says

Man, 68, drowns at Caesar Creek Lake
5/26/12
Water rescues prompt warning from health officials
5/25/12
Beach Waterpark sued for failure to deliver
5/25/12
Raleigh Trammell’s defense opens in felony trial
5/25/12
UD to move satellite campus to Dublin
5/25/12
> More headlines

By Ben Sutherly, Staff Writer Updated 10:25 PM Wednesday, August 25, 2010

DAYTON — Births in Ohio have hovered around 150,000 in recent years. Officials at the Children’s Medical Center of Dayton and Miami Valley Hospital said they’re seeing a decline so far this year in the number of infants requiring the most critical care.

That’s one reason why the region doesn’t need Kettering Medical Center to open a third neonatal intensive care unit for extremely premature and critically ill newborns, they said. Such NICUs are typically classified as Level III.

“I think if Dayton were a market that was growing rapidly, we would be having a different conversation,” said Vicki Giambrone, Dayton Children’s vice president for marketing and external relations.

Kettering Medical Center’s efforts to staff a Level III NICU using local expertise have been unsuccessful so far, and officials there said the hospital has broadened its search nationally.

KMC currently has a Level II nursery, and officials have discussed its proposed Level III upgrade in terms of choice, adding it’s “paramount” that mother and baby be able to stay near one another when the baby needs intensive care.

They have said benchmarks would be put in place to ensure quality.

Roy Chew, KMC’s president, said last year that, if anything, competition enhances quality instead of diminishing it.

Still, Dayton Children’s officials called KMC’s ongoing push to upgrade its NICU worrisome and disappointing.

Officials from the two hospitals last met in May to discuss the NICU and have spoken by telephone since then, according to Giambrone.

Dayton Children’s feels research is on its side. It cited a 2006 German study, a 1995 Pediatrics study and a 2007 New England Journal of Medicine study, all of which concluded that survival rates were higher at larger NICUs or that regionalization was a preferred approach.

“Regionalization becomes important when you take care of a problem that’s highly critical but in low volume,” said Dr. Marc Belcastro, medical director of Miami Valley’s Level III NICU.

“If you take the sickest babies (and) dilute their care across multiple systems, everyone then is exposed to a lower volume.”

Over time, that can take a subtle toll on competencies, Belcastro said. Medical professionals who don’t have the opportunity to use their highly specialized skills regularly might lose their edge, he said, creating a risk to infants.

KMC spokesman Kevin Lavoie said the hospital’s decision to open a Level III NICU came in response to requests from physicians and patients.

Miami Valley in May 2009 opened a $19 million, 51,000-square-foot NICU with private rooms for 60 babies and their families. A decade ago, that hospital had 49 NICU beds.

Dayton Children’s NICU has 41 beds, but it is entirely focused on Level III care and provides more care for newborns needing that care than Miami Valley Hospital.

Dayton Children’s also is the region’s only hospital that provides surgical services for newborns.

Dayton Children’s officials claim the viability of their hospital — one of only 50 free-standing children’s hospitals nationwide — is at stake.

According to the hospital’s most recent federal nonprofit tax form, the hospital’s revenues (minus expenses) for fiscal 2008-09 were $13.3 million, down from $31.4 million in 2007-08. The drop was mostly due to a decline in investment income in fiscal 2008-09.

“If you look around the country, there aren’t many children’s hospitals in markets that are Dayton’s size,” said Matt Graybill, vice president for business development and planning. “It takes a community effort to keep this resource strong.”

Contact this reporter at (937) 225-7457 or bsutherly@DaytonDaily News.com.

Share this article