Changing Landscape of Routine Pediatric Surgery for Rural and Urban Children
Samir K. Gadepalli, Harold J. Leraas, Katherine T. Flynn-O’Brien, Kyle J. Van Arendonk, Matt Hall, Elisabeth T. Tracy, Robert L. Ricca, Adam B. Goldin, Peter F. Ehrlich- Surgery
Objective:
To describe the changes to routine pediatric surgical care over the past 2 decades for children living in urban and rural environments.
Background:
A knowledge gaps exists regarding trends in the location where routine pediatric surgical care is provided to children from urban and rural environments over time.
Methods:
Children (age 0–18) undergoing 7 common surgeries were identified using State Inpatient Databases (SID, 2002–2017). Rural-Urban Commuting Area codes were used to classify patient and hospital zip codes. Multivariable regression models for distance traveled >60 miles and transfer status were used to compare rural and urban populations, adjusting for year, age, sex, race, and insurance status.
Results:
Among 143,467 children, 13% lived in rural zip codes. The distance traveled for care increased for both rural and urban children for all procedures but significantly more for the rural cohort (eg, 102% vs 30%,
Conclusion:
Rural children, younger age, and those on Medicaid disproportionately traveled greater distances and were more frequently transferred for common pediatric surgical procedures.