Hospital consolidation linked to closure of inpatient pediatric services

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.