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September 2015

The Concern for Supply-Sensitive Neonatal Intensive Care Unit Care: If You Build Them, They Will Come

Author Affiliations
  • 1Center for Pediatric and Adolescent Comparative Effectiveness Research, School of Medicine, Indiana University, Indianapolis
  • 2Center for Health Policy and Professionalism Research, School of Medicine, Indiana University, Indianapolis
JAMA Pediatr. 2015;169(9):812-813. doi:10.1001/jamapediatrics.2015.1597

When people acknowledge that life expectancy has increased dramatically in the past 5 decades, many mistakenly believe it is because of huge improvements in care for diseases that affect adults and the elderly at the end of their lives. What is missed is that many, if not most, of the gains we have seen are the result of saving the lives of children and infants. Saving an infant adds many more years to overall life expectancy at birth than does prolonging an older person’s life for a few years.

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    1 Comment for this article
    Further marginlization of the general pediatrician
    Abraham Bergman | University of Washington and Harborview Medical Center
    This is an absolutely wonderful editorial, though perhaps a bit too polite. I don't think gross venality is the chief cause of NICU overuse. Rather it our pediatric educational system decreeing that any sick infant or child has to be seen by some 'ologist. Dyspnea, tachycardia, or high fever is enough to dispatch a patient from the ward to the ICU. All heart murmers must be evaluated by cardiologists, potential abuse victims must be referred to \"abuse specialists,\" and a child with ethical issues referred to \"ethicists.\" Not clergy, not experienced pediatricians. Ethicists! The general pediatrician? Well child care, immunizations, and handing out books.