{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T17:41:42Z","timestamp":1786470102261,"version":"build-2736575974"},"reference-count":46,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate 25\u2010year national trends in paediatric intensive care utilisation, patient outcomes, rehospitalisations and regional resource distribution in Israel.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective, population\u2010based cohort study of all paediatric (0\u201317\u2009years) ICU hospitalisations in Israel between 1999 and 2023. We linked the National Hospital Discharge Register with paediatric ICU bed capacity data and Central Bureau of Statistics population estimates. Outcomes included age\u2010adjusted ICU admission rates, in\u2010hospital and 1\u2010year post\u2010discharge mortality, rehospitalisation at 7, 30 and 365\u2009days, and paediatric ICU beds per 100\u2009000 children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The proportion of hospitalisations involving ICU care increased from 3.53% to 6.1%. In\u2010hospital ICU mortality declined from 4.3% to 2.3%, and 1\u2010year post\u2010discharge mortality decreased from 3.2% to 2.6%. One\u2010year rehospitalisation occurred in 46% of ICU survivors versus 29% of non\u2010ICU patients. Between 2018 and 2023, national paediatric ICU bed capacity rose by 23%, yet regional bed\u2010to\u2010population ratios varied up to 2.6\u2010fold.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Over 25\u2009years, paediatric ICU utilisation and capacity nearly doubled, accompanied by reductions in mortality. However, persistently high rehospitalisation rates and regional disparities underscore the need for structured post\u2010ICU follow\u2010up, standardised admission criteria, equitable resource allocation and further research to clarify drivers of ICU utilisation and long\u2010term outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apa.70577","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T12:53:36Z","timestamp":1777553616000},"page":"1899-1909","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Survival to Recovery: 25\u2009Years of Paediatric Critical Care Transformation in Israel"],"prefix":"10.1111","volume":"115","author":[{"given":"Yael","family":"Applbaum","sequence":"first","affiliation":[{"name":"Division of Health Information Ministry of Health  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shulamit","family":"Gordon","sequence":"additional","affiliation":[{"name":"Division of Health Information Ministry of Health  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Manaster","sequence":"additional","affiliation":[{"name":"Section of Pediatric Critical Care Hadassah University Medical Center  Jerusalem Israel"},{"name":"Faculty of Medicine The Hebrew University of Jerusalem  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziona","family":"Haklai","sequence":"additional","affiliation":[{"name":"Division of Health Information Ministry of Health  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Mendlovic","sequence":"additional","affiliation":[{"name":"Division of Health Information Ministry of Health  Jerusalem Israel"},{"name":"Faculty of Medicine The Hebrew University of Jerusalem  Jerusalem Israel"},{"name":"Department of Pediatrics Shaare Zedek Medical Center  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adi","family":"Avniel Aran","sequence":"additional","affiliation":[{"name":"Section of Pediatric Critical Care Hadassah University Medical Center  Jerusalem Israel"},{"name":"Faculty of Medicine The Hebrew University of Jerusalem  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4575-3888","authenticated-orcid":false,"given":"Uri","family":"Pollak","sequence":"additional","affiliation":[{"name":"Section of Pediatric Critical Care Hadassah University Medical Center  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1203\/01.PDR.0000182822.16263.3D"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-0704(18)30264-1"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0022\u20103476(97)70124\u20100"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e3181ce7427"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000558"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2023.01.008"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000498"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2023.01.002"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2023.01.008"},{"issue":"6","key":"e_1_2_12_11_1","first-page":"1","article-title":"Israel: Health System Review","volume":"17","author":"Rosen B.","year":"2015","journal-title":"Health Systems & Reform"},{"key":"e_1_2_12_12_1","volume-title":"Statistical Abstract of Israel 2021 \u2013 No. 72","author":"Central Bureau of Statistics","year":"2021"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31824e68cf"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e3182917fad"},{"key":"e_1_2_12_15_1","first-page":"1","volume-title":"Nelson Textbook of Pediatrics 21st ed","author":"Kliegman R. 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