Trends in Pediatric Hospital Services: Current Challenges

A study in Pediatrics found a large rise in hospitals classified as providing minimal pediatric services from 2003 to 2022.

The analysis of nearly 4,000 hospitals documented a 137% increase in facilities meeting minimal pediatric capabilities over the period. Investigators evaluated 24 discrete pediatric capabilities and reported declines in 17, with the largest drops in common surgical procedures and respiratory-care capabilities.

Immediate clinical consequences include longer transfer times and regional access gaps, especially for families remote from tertiary centers. That regionalization can delay care for time-sensitive conditions such as appendicitis or severe asthma exacerbations and complicate logistics for inpatient treatment—effectively widening disparities in timely pediatric inpatient care.

Key drivers appear to be workforce shortages, pediatric bed closures, and payment structures that disincentivize local pediatric capacity—most notably low Medicaid reimbursement.