The medical community has recognized for more than 150 years that children of all ages have unique medical needs, that they are not just "miniature adults." In fact, the first children's hospital established in the English-speaking world was the Hospital for Sick Children, which opened in London in 1852. Three years later, the first American children's hospital, the Children's Hospital of Philadelphia, opened its doors.

Today, residents in large and small communities across the United States have access to specialized pediatric health care at an estimated 250 children's hospitals or children's hospitals within adult medical centers, according to NACHRI, the National Association of Children's Hospitals and Related Institutions, of which East Tennessee Children's Hospital is a member. This represents less than five percent of our nation's hospitals.

Although children's hospitals are but a small percentage of hospitals in the United States, they treat the vast majority of serious medical conditions in children (such as transplants, cancer and cystic fibrosis), as well as a significant percentage of more common childhood conditions and health care needs (such as tonsillectomies, respiratory illnesses and emergencies).

More than 3 million children are hospitalized annually nationwide. Children's hospitals treat more than 1 million, or about a third, of these hospitalized (inpatient) children. Children's hospitals account for more than 40 percent of inpatient days and 50 percent of costs for all children hospitalized in the U.S. -- $11 billion worth of care annually. Across the nation, about 2.3 million emergency department visits and 13 million outpatient visits are made to children's hospitals annually.

Children who receive care from children's hospitals span all ages, economic backgrounds and racial and ethnic minority groups. Of the children discharged from children's hospitals in 2006, 58 percent were under age 5, 42 percent were low-income and 42 percent were minorities.

Children's hospitals are regional referral centers, meeting the specialized care needs of children from distant communities as well as the closest neighborhood, according to NACHRI. Freestanding children's hospitals, such as East Tennessee Children's Hospital, represent only one percent of all U.S. hospitals, but they care for 25 percent of all hospitalized children with congenital or chronic conditions.

Freestanding children's hospitals also train 35 percent of all pediatricians and nearly half of all pediatric subspecialists. Factor in pediatric departments of major teaching hospitals, and children's hospitals train the large majority of pediatricians and virtually all pediatric subspecialists.

Children's hospitals also train nurses, occupational therapists, social workers, dentists and other health professionals who dedicate their careers to working with the health care needs of children. In fact, over 80 percent of children's hospitals provide education for future nurses, and at least half of children's hospitals offer educational programs in undergraduate respiratory therapy, child life and graduate social work.

Children's hospitals serve as premiere pediatric research centers and also advocate child health protections by tackling such issues as injury prevention, child abuse, neglect and child obesity.

Children's hospitals are the nation's "safety net" for the poorest children, the sickest children, and children with the most specialized care needs. Safety net providers serve a large volume of low-income patients, including children on Medicaid (TennCare in Tennessee) and those without insurance; provide highly complex medical services to treat severely ill patients; provide clinical and social services; and provide specialized care benefiting the entire community. Virtually all children's hospitals are designated by their states as "disproportionate share hospitals" because they devote a disproportionate share of their care to patients who are assisted by Medicaid or who are uninsured. In fact, Medicaid accounts for more than 55 percent of the inpatient care and 48 percent of outpatient care at freestanding, acute care children's hospitals. Children's hospitals strive to provide care to children even when it results in financial loss.

Children's hospitals may be freestanding and independent (such as East Tennessee Children's Hospital), part of a hospital system, teaching hospitals, children's hospitals located within major hospitals or specialty children's hospitals (such as orthopedic, rehabilitation or psychiatric facilities). But they all share the same goal – to provide the most appropriate care to their patients, according to their unique needs, which include:

• Medical equipment that is sized just for them, from blood pressure cuffs to needles to wheelchairs, and many other items.
• The reassuring presence of their families – not just parents but also siblings, grandparents, other close relatives and close family friends – whenever possible, day or night.
• Health care providers who understand the differences between children's bodies and adult bodies.
• A kid-sized and child-friendly environment full of color, fun art and plenty of toys.
• Health care providers who understand that children get different illnesses and react differently to some illnesses than adults do.
• Pediatric-trained medical, nursing and clinical staff who recognize the emotional, behavioral and educational needs of sick children.
• Specialized medications.
• Health care availability regardless of their parents' ability to pay or health insurance coverage. Whether a child's health care needs are simple or complex, common or rare, children's hospitals such as East Tennessee Children's Hospital are best prepared to meet those needs.

Source: NACHRI, the National Association of Children's Hospitals and Related Institutions