Academic Journal
A national geospatial analysis of pediatric surgical practices and the children they serve.
| Title: | A national geospatial analysis of pediatric surgical practices and the children they serve. |
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| Authors: | Ricca R; Division of Pediatric Surgery, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA. Electronic address: rricca@pennstatehealth.psu.edu., Greene AC; Department of Surgery, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA., Vu MT; Expeditionary Medical Facility 150 Mike, Naval Hospital Jacksonville, 2080 Child St., Jacksonville, FL, 32214, USA., Hamilton NA; Peacehealth RiverBend, 3333 RiverBend Dr., Springfield, OR, 97477, USA., Ladd MR; Department of Surgery, Wake Forest University School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC, 27157, USA., Lotakis DM; Indiana University, Riley Hospital for Children, 705 Riley Hospital Drive, Indianapolis, IN, 46201, USA., Robie DK; Dayton Children's Hospital, One Children's Plaza, Dayton, OH, 45404, USA., Romain C; University of Chicago, 5839 S. Maryland Ave., Chicago, IL, 60637, USA., Edwards MJ; Albany Medical College, Albany, NY, 12208, USA., Kennedy AP Jr; Janet Weis Children's Hospital, Geisinger Health System, 100 N Academy Ave, Danville, PA, 17822, USA., Zagory JA; Division of Pediatric Surgery, Department of Surgery, LSU Health New Orleans, 2021 Perdido Street, New Orleans, LA, 70112, USA., Sutyak KM; University of Nebraska Medical Center, Omaha, NE, 68198, USA., Fallat ME; Department of Surgery, University of Louisville School of Medicine, Norton Children's Hospital, 315 E Broadway, Suite 565, Louisville, KY, 40202, USA., Zeug A; ThedaCare, 100 Theda Clark Plaza Suite $400, Neenah, WI, 54956, USA., Chandler NM; Division of Pediatric Surgery, Johns Hopkins All Children's Hospital, 501 6th Street South, Saint Petersburg, FL, 33701, USA., Badru FO; CAMC Pediatric Surgery, Vandalia Health, 830 Pennsylvania Ave., Suite 202, Charleston, WV, 25302, USA., Wadie G; Carolina Pediatric Surgery, 400 Asheville Ave., Suite 200 B, Cary, NC, 27518, USA., Iocono J; Department of Surgery, Akron Children's Hospital, 215 West Bowery St., 6th Floor, Akron, OH, 44308, USA., Wolf LL; Division of Pediatric Surgery, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, AR, 72022, USA., Purcell LN; Division of Pediatric Surgery, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA., Browne M; Division of Pediatric Surgery, Lehigh Valley Health Network, 1210 S Cedar Crest Blvd, Suite 1100, Allentown, PA, 18103, USA., Bonasso Ii PC; WVU Medicine Golisano Children's Hospital, 1 Medical Center Drive, Morgantown, WV, 26506, USA., Prasad R; St. Luke's Children's Hospital, 701 Ostrum Street, Suite 102, Bethlehem, PA, 18015, USA., Alaish SM; Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA., DeRoss AL; Division of Pediatric General Surgery, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, 9500 Euclid Avenue, R3, Cleveland, OH, 44195, USA., Jang SG; School of Marine and Atmospheric Sciences, Stony Brook University, Stony Brook, NY, 11794, USA., Martin AE; 324 Colony Blvd, Lexington, KY, 40502, USA., Gow KW; Division of Pediatric Surgery, Stony Brook University Hospital, 101 Nicolls Road, Stony Brook, NY, 11794, USA. |
| Source: | Journal of pediatric surgery [J Pediatr Surg] 2026 Aug 29, pp. 163432. Date of Electronic Publication: 2026 Aug 29. |
| Publication Model: | Ahead of Print |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Saunders Country of Publication: United States NLM ID: 0052631 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-5037 (Electronic) Linking ISSN: 00223468 NLM ISO Abbreviation: J Pediatr Surg Subsets: MEDLINE |
| Imprint Name(s): | Publication: Philadelphia, PA : Saunders Original Publication: New York. |
| Abstract: | Purpose: This study characterizes the geographic distribution of pediatric surgical practices in the U.S. relative to the pediatric population (ages 0-17 years). Prior analyses estimated that over 10 million children (14.8%) live more than 60 miles from a pediatric surgeon, overlooking outreach clinics that extend access and reduce travel distances. Our goal was to generate a more accurate assessment of travel burden using data that includes all practice locations. Methods: The APSA membership directory was used to identify pediatric surgery practices. Practices were contacted for information on faculty and the number and location of hospitals and clinics as of July 31, 2025. Practice locations were compared to population demographics from the US 2020 Census data calculating straight-line driving distances both across and within state lines. Results: A total of 248 unique primary hospital and clinic sites were identified. An additional 684 hospital locations and 512 clinic locations were also identified. The average travel distance to the practice's primary location (hospital or clinic) for children traveling across state lines (ASL) was 55.0 miles, and within states travel (WSL) was 63.4 miles, with 13.2% of children living >60 miles from care (n = 9,662,011). Including all 932 hospitals served by these practices, average distances decreased slightly to 50.3 miles ASL and 58.2 miles WSL, with 11.1% > 60 miles (n = 8,125,546). For the 248 primary clinics; distances to care were similar to those from the primary hospitals. Considering all clinics (n = 760), distances decreased to 41.5 miles ASL and 48.1 miles WSL, with only 6.7% of children >60 miles away (n = 4,928,417). Conclusions: Pediatric surgical care is unevenly distributed in the United States. Both outreach hospitals and clinics can positively impact travel distances for patients. This impact is even greater when children are allowed to cross state lines for pediatric surgical care. These findings support workforce planning and resource allocation to ensure pediatric surgeons are available where children need them most. (Copyright © 2026 Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ME Fallat, MD, serves as an Associate Editor at the Journal of Pediatric Surgery. KW Gow, MD, and NM Chandler, MD, serve as Assistant Editors at the Journal of Pediatric Surgery. Given their role as Associate or Assistant Editors of the Journal of Pediatric Surgery, they had no involvement in the peer review of this article and had no access to information regarding its peer review. Full responsibility for the editorial process for this article was delegated to another journal editor. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| Contributed Indexing: | Keywords: Access-to-care; Distance-to-care; Geographic disparities; Pediatric surgery; Workforce distribution |
| Entry Date(s): | Date Created: 20260829 Latest Revision: 20260915 |
| Update Code: | 20260916 |
| DOI: | 10.1016/j.jpedsurg.2026.163432 |
| PMID: | 42667980 |
| Database: | MEDLINE |
| ISSN: | 1531-5037 |
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| DOI: | 10.1016/j.jpedsurg.2026.163432 |