U.S. hospitals increasingly offer less-comprehensive pediatric care, which could narrow children’s access to care, according to a 20-year review published Dec. 10 in Pediatrics.
Researchers examined an average of 3,927 hospitals annually between 2003 and 2022 using the Healthcare Cost and Utilization Project Kids’ Inpatient Database.
They found that hospitals classified as “low-capability” in terms of pediatric care offerings more than doubled over the study period. Specifically, level 4 hospitals — those offering minimal pediatric services — increased by 137%. At the same time, all hospitals offering higher levels of pediatric care, levels 1, 2 and 3, declined by 38%, 54% and 48%, respectively.
The steepest reductions in pediatric service offerings were seen in moderate-intensity care, including appendectomy (down 50.5%), pneumonia hospitalization (down 42.3%) and asthma hospitalization (down 41.1%). Meanwhile, high-complexity services, such as extracorporeal membrane oxygenation, organ transplant and Fontan surgery saw minimal change over the 20-year period.
The findings come as hospitals continue to wind down pediatric services amid mounting workforce and financial pressures. In November, Becker’s reported on the top challenges straining pediatric care — including insufficient reimbursement, lower compensation and a shortage of trained professionals — which leaders say could significantly limit access to high-quality care for children moving forward.
