Variability of Pediatric Surgical Care Delivery Based on Hospital Setting.

INTRODUCTION: Pediatric surgeons provide a broad array of medical and surgical services in diverse care environments across various institutional settings. This spectrum includes large, free-standing children's hospitals and small pediatric units within predominantly adult hospitals. However, it is unclear how differences in hospital setting affect pediatric surgical practice and the delivery of pediatric surgical care. METHODS: To better understand the effect hospital setting may have on the delivery of pediatric surgical care, a survey was administered to pediatric surgeons serving on surgical committees of the American Academy of Pediatrics, Section on Surgery, to gather perspectives on the hospital settings where they provide care. Data were categorized based on hospital type including free-standing children's hospitals, children's hospital/unit within an adult hospital, and children's hospital with an adjacent adult hospital. RESULTS: A total of 60 pediatric surgeons responded to the survey (44% response rate), 45% from free-standing children's hospitals. Our findings revealed distinct advantages and disadvantages perceived by surgeons associated with each type of hospital setting. Notably, access to dedicated pediatric operating rooms and adult surgical specialists was highlighted as particularly beneficial for pediatric surgical care delivery. Access to various subspecialties varied depending on the hospital setting. CONCLUSIONS: Collectively, these data provide valuable insights on factors that foundationally impact pediatric surgical care delivery, which may vary by hospital setting. Access to pediatric operating rooms, pediatric subspecialists, and adult surgeons were identified as key determinants of effective pediatric surgical care. These data may provide a roadmap in the advocacy for key resources to enhance the surgical care of children.