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Hospitals are closing unprofitable pediatric units and eliminating some surgical services for kids as they grapple with lower Medicaid reimbursements, staffing issues and more complicated cases, a 20-year review in the journal Pediatrics found.

Why it matters: 

The cuts can erect additional hurdles to getting care in already underserved communities and require families to travel longer distances to regional or urban health centers.

What they found: 

The review of nearly 4,000 facilities from 2003 to 2022 found the proportion of hospitals that researchers identified as having the lowest capabilities for pediatric care more than doubled.

• The most common services shed were appendectomies (50.5% fewer hospitals), hospitalizations for pneumonia (42.3%) and asthma hospitalizations (41.1%).
• In contrast, capabilities like organ transplantation and open-heart surgery for congenital defects showed little to no change.

The intrigue: 

Hospitalizations for children fell 26% from 2000 to 2019, prompting more hospital operators to take pediatric inpatient units offline, with little incentive to bring them back.

• The resulting regionalization of pediatric care “has not shown signs of slowing, and it remains to be seen whether there is a floor on pediatric capacity,” they wrote.

Yes, but: The lack of pediatric inpatient beds doesn’t mean that a hospital will not admit a child on an adult ward.