The Regionalization of Pediatric Health Care abstract

Regionalization of health care is a method of providing high-quality, cost-efficient health care to the largest number of patients. Within pediatric medicine, regionalization has been undertaken in 2 areas: neonatal intensive care and pediatric trauma care. The supporting literature for the regionalization of these areas demonstrates the range of studies within this field: studies of neonatal intensive care primarily compare different levels of hospitals, whereas studies of pediatric trauma care primarily compare the impact of institutionalizing a trauma system in a single geographic region. However, neither specialty has been completely regionalized, possibly because of methodologic deficiencies in the evidence base. Research with improved study designs, controlling for differences in illness severity between different hospitals; a systems approach to regionalization studies; and measurement of parental preferences will improve the understanding of the advantages and disadvantages of regionalizing pediatric medicine and will ultimately optimize the outcomes of children. Pediatrics 2010;126:1182–1190 AUTHORS: Scott A. Lorch, MD, MSCE,a,b,c,d,e Sage Myers, MD,a and Brendan Carr, MD, MSd,e,f aDepartment of Pediatrics and cCenter for Outcomes Research, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; bDivision of Neonatology, Department of Pediatrics, fDepartment of Emergency Medicine, and eCenter for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; and dSenior Scholar, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania