Data from University of Michigan Advance Knowledge in Managed Care [Changing Landscape of Routine Pediatric Surgery for Rural and Urban Children a Report From the Child Health Evaluation of Surgical Services (Chess) Group]: Managed Care

2023 NOV 09 (NewsRx) -- By a News Reporter-Staff News Editor at Hospital & Nursing Home Daily -- Investigators discuss new findings in Managed Care. According to news originating from Ann Arbor, Michigan, by NewsRx correspondents, research stated, “To describe the changes to routine pediatric surgical care over the past 2 decades for children living in urban and rural environments. 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.”

Our news journalists obtained a quote from the research from the University of Michigan, “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. 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%, P<0.001, cholecystectomy). Transfers also increased for rural children (eg, transfers for appendectomy increased from 1% in 2002 to 23% in 2017, P<0.001). Factors associated with the need to travel >60 miles included year [adjusted odds ratio (aOR)=2.18, 95% CI: 1.94-2.46: 2017 vs 2002], rural residence (aOR=6.55, 95% CI: 6.11-7.01), age less than 5 years (aOR=2.17, 95% CI: 1.92-2.46), and Medicaid insurance (aOR=1.35, 95% CI: 1.26-1.45). Factors associated with transfer included year (aOR=5.77, 95% CI: 5.26-6.33: 2017 vs 2002), rural residence (aOR=1.47, 95% CI: 1.39-1.56), age less than 10 years (aOR=2.34, 95% CI: 2.15-2.54), and Medicaid insurance (aOR=1.49, 95% CI: 1.42-1.46).”

According to the news editors, the research concluded: “Rural children, younger age, and those on Medicaid disproportionately traveled greater distances and were more frequently transferred for common pediatric surgical procedures.”

This research has been peer-reviewed.

For more information on this research see: Changing Landscape of Routine Pediatric Surgery for Rural and Urban Children a Report From the Child Health Evaluation of Surgical Services (Chess) Group. Annals of Surgery, 2023;278(4):530-537. Annals of Surgery can be contacted at: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA. (Lippincott Williams and Wilkins - www.lww.com; Annals of Surgery - http://journals.lww.com/annalsofsurgery/pages/default.aspx)

The news correspondents report that additional information may be obtained from Samir K. Gadepalli, University of Michigan, Dept. of Surgery, Section of Pediatric Surgery, Michigan Medicine, Ann Arbor, MI 48109, United States. Additional authors for this research include Peter F. Ehrlich, Harold J. Leraas, Elisabeth T. Tracy, Katherine T. Flynn-O’Brien, Kyle J. Van Arendonk, Matt Hall, Robert L. Ricca and Adam B. Goldin.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1097/sla.0000000000005990. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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