Globally, how did paediatrics originate as a speciality? How does India compare in terms of primary and tertiary care in paediatrics?
Paediatrics as a speciality has been in existence for over 400 years. The first paediatric hospital globally, Hôpital des Enfants Malades, was started in Paris in 1802 and was taking care of patients up to the age of 15 years. Currently, children’s hospitals worldwide are of substantial size in terms of beds, with 500-600 beds in the larger ones and 150-200 beds in mid-sized ones. In the United States, there are 250 children’s hospitals — one children’s hospital for every 20 adult hospitals. As much as 97 per cent of all children’s operations in the United States are done in children’s hospitals, including complex procedures like heart surgeries, brain surgeries and organ transplants for children.
In India, paediatrics as a speciality has come up in the last few decades. In the early days, children’s hospitals were mostly run by trusts or the government sector. In the last two decades, a visible trend witnessed is that of paediatric-focused hospitals and also mother and baby boutique hospitals in the private sector. These hospitals have come up mainly in metro cities across the country. However, children’s multi-speciality focus to address the tertiary and quaternary care is still in the nascent stage even in the large metro cities. While paediatric hospitals in the government or trust segments continue to serve a large number of paediatric patients from all sections of society, they clearly have not progressed in offering complex multi-speciality care as well as quaternary care for children.
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