Hospital consolidation is associated with closure of inpatient pediatric services within five years, according to a research letter published online June 20 in JAMA Pediatrics.
Allan M. Joseph, M.D., M.P.H., from the University of Pittsburgh School of Medicine, and colleagues conducted a longitudinal study of U.S. hospitals using the 2011 to 2020 American Hospital Association annual surveys to characterize whether hospital consolidation is associated with loss of inpatient pediatric services. A total of 5,104 unique hospitals, representing 46,841 hospital-years, were examined.
The researchers observed a decline in the provision of inpatient pediatric services over time, from 41.5 percent of 4,876 in 2011 to 32.6 percent of 4,551 in 2020. Joining a hospital system was associated with a loss of inpatient pediatric services within five years (adjusted odds ratio, 1.57; 95 percent confidence interval, 1.26 to 1.96; P < 0.001). This association remained statistically significant at four years, but not at shorter follow-up lengths in sensitivity analyses with varying follow-up periods. The association between joining a health system and loss of inpatient pediatric services was not significant in a proportional hazards analysis (adjusted hazard ratio, 1.23; 95 percent confidence interval, 0.95 to 1.61; P = 0.13).
“Policy makers should consider the potential loss of inpatient pediatric services when reviewing proposed hospital mergers and acquisitions,” the authors write.
Allan M. Joseph et al, Association Between Hospital Consolidation and Loss of Pediatric Inpatient Services, JAMA Pediatrics (2023). DOI: 10.1001/jamapediatrics.2023.1747
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