request for information to all of the 16 member hospitals (Appendix 1). Essentially, the request went out seeking information on the admission practices in Canadian cities where both Tertiary care hospitals and Community hospitals with paediatric inpatient units co-exist.
Of the 16 centers, seven centers (, Centre Hospitalier Universitaire de Sherbroke, Children’s Hospital of Eastern Ontario, Hopital Ste Justine, Kingston General Hospital., McMaster Children’s Hospital, and Montreal Children’s Hospital) did not respond to the email. Five other centers ( , , Saskatoon Health Authority, IWK Health Center – Halifax) responded that all paediatric admissions were directed exclusively to the Tertiary care facility in their cities. Three centers (Stollery Children’s Hospital, BC Children’s Hospital and Sick Kid’s Hospital) all responded that they have both Tertiary Care Centers and Community Hospitals, and these centers have policies in place concerning admission practices for paediatric patients.
Edmonton has a major tertiary care center and 2 community hospital centers to which paediatric patients can be admitted and a third site where Neonates can be admitted. No formal process is in place to determine where paediatric patients are admitted. Two conflicting messages were obtained when speaking with experts in Edmonton. A representative from the Stollery described plans to centralize all admissions at their hospital and alluded to the fact that the community hospital beds might be reallocated to other programs. A second view was expressed by a paediatrician who works at one of the community hospitals. She stated that the unit, while small, is often full to capacity especially in the winter months, and that she had heard no definitive plans to close the unit.
In Vancouver, the BC Children’s Hospital is the paediatric tertiary care center. Attempts are made to repopulate community centers with suitable patients (ie children from Vancouver proper and needing a specialist, TPN, complex medical care, orthopedics, complex trauma care, cardiac surgery/care, are less than 6 month old – in select cases) would be sent to their own community hospital. Also, attempts are made to repopulate patients once admitted at appropriate times in the child’s recovery. Adolescent