Public Health Open Access (PHOA)
ISSN: 2578-5001
Research Article
Measuring What Matters: Data Gaps, Certificate of Need Reform,
and Pediatric Psychiatric Inpatient Capacity in North Carolina
Abstract
Access to pediatric inpatient psychiatric services is increasingly constrained, yet statewide psychiatric infrastructure remains
difficult to measure due to fragmented and inconsistent public reporting systems. This study examined the relationship
between Certificate of Need (CON) reform, infrastructure visibility, and the measurability of pediatric inpatient psychiatric
capacity in North Carolina.
A cross-sectional health policy and infrastructure analysis was conducted using publicly accessible regulatory, licensing,
organizational, and secondary reporting systems. The analysis evaluated the extent to which pediatric psychiatric infrastructure
could be identified and quantified across facility types and reporting pathways.
A total of 16 facilities and health system entities were identified as providing or planning paediatric inpatient psychiatric
services in North Carolina. Among these, 12 facilities had publicly measurable pediatric psychiatric bed counts, while 4
acknowledged paediatric psychiatric services without reporting quantitative capacity information. Freestanding psychiatric
hospitals were substantially more visible within regulatory reporting systems than hospital-based psychiatric units. Most
measurable paediatric psychiatric bed counts were derived from historical Certificate of Need findings and approval documents.
These findings suggest that fragmented reporting environments limit statewide behavioural health planning and infrastructure
assessment. The inability to consistently measure paediatric psychiatric capacity represents a healthcare infrastructure and
policy problem in itself.
Keywords: Pediatric Inpatient Psychiatry; Certificate of Need (CON) Reform; Behavioral Health Infrastructure
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