Three years ago Riley Hospital for Children opened a psychiatric unit amid much fanfare, saying it would provide much-needed care for children and adolescents with conditions ranging from anxiety to eating disorders to bipolar disorder.

But this spring, the hospital quietly shuttered the 20-bed unit, which included safe rooms especially designed for patients who might harm themselves.

And Riley is not the only hospital to make such a decision, experts say, as insurers direct patients to treatments that don't involve expensive hospitalizations.

The closing at Riley does not leave the parents of troubled children without options, but it does come at a time when advocates for pediatric mental health services decry a lack of resources, including available hospital beds for patients whose needs cannot be addressed outside of a hospital setting.

Yet hospital officials declined to go into detail about the rationale behind the closure. In an emailed statement Riley officials said only that they were considering the best way to provide dedicated behavioral health services.

KARANGASEM - Gempa berkekuatan 5,8 Skala Richter (SR) yang mengguncang Bali pada Selasa (16/7/2019) pagi dirasakan kuat di Kabupaten Karangasem, Bali. Bahkan sempat membuat warga panik. Di RSUD Karangasem, sejumlah pasien anak-anak langsung diungsikan ke luar ruang perawatan pascagempa pada Selasa pagi. 

Hingga kini mereka takut dan menolak masuk ke dalam ruangan perawatan karena takut terjadi gempa susulan (after shock). Kondisi ini membuat pasien sementara diungsikan di halaman Rumah Sakit Umum Daerah (RSUD) Karangasem sampai kondisi tenang kembali. Nyoman Sumantara keluarga pasien berharap pihak rumah sakit dapat memberikan arahan pada pasien apabila terjadi gempa susulan.

A simmering US health crisis has bubbled to the surface. As the global maternal mortality rate fell 44 percent between 1990 and 2015, maternal mortality and pregnancy-related deaths in the US have gone in the opposite direction, increasing 139 percent since 1987. The stark disparities by race have persisted for the past six decades, with black women still three to four times more likely to die pregnancy-related deaths in the US as the rates continue to climb. This is a serious problem without a simple solution, but one finally getting the attention it deserves from policy makers and the general public. Significantly reversing the trend will require honest introspection about the health care system’s role in contributing to the increasingly poor outcomes and high costs of maternity care.

Under the current system, the total payment for a pregnancy and birth includes professional services fees for prenatal care, labor, birth, and postpartum care, in addition to facility fees for the birth and cesarean section, if applicable. Some insurance plans will group all professional fees for maternity-related services under a “global maternity fee,” reimbursed to the individual or group obstetrics practice, while professional fees and facility fees for newborn care are almost always billed separately.


Pusat Kebijakan dan Manajemen Kesehatan (PKMK)
Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan (FK-KMK) Universitas Gadjah Mada

Jl. Medika - depan LPPT UGM, Senolowo, Sinduadi, Kec. Mlati, Kabupaten Sleman, Daerah Istimewa Yogyakarta 55281

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