Researchers examined 5,104 hospitals in a longitudinal study using the 2011 to 2020 American Hospital Association annual surveys. Hospitals were categorized by self-reported provisions of pediatric inpatient care, and researchers followed them up until they joined a system.
Their analysis found provision of inpatient services declined from 2011 to 2020. Joining a system was associated with closing inpatient pediatric services within five years. The association remained statistically significant at four years but not at shorter follow-ups.
In the paper’s discussion, researchers said: “Hospital consolidation, as measured by newly reported membership in a health system, was associated with closure of existing inpatient pediatric services within five years, potentially exacerbating this trend. These findings are limited by the nature of a survey-based dataset, which is vulnerable to non-response bias, though the response rate for this survey is annually quite high. Future research should explore how inpatient unit closures are affecting observed access to pediatric acute care, particularly in the context of known geographic variation in access.”
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