Low Capability Pediatric Hospitals More Than Doubled From 2003 to 2022

WEDNESDAY, Dec. 10, 2025 (HealthDay News) — From 2003 to 2022, there was a more than doubling in low-capability pediatric hospitals, according to a study published online Dec. 10 in Pediatrics.

Kenneth A. Michelson, M.D., M.P.H., from Ann & Robert Lurie Children”s Hospital in Chicago, and colleagues examined the change in availability of pediatric-capable hospitals from 2003 to 2022 using the Healthcare Cost and Utilization Project Kids” Inpatient Database. The annual proportion of hospitals was determined by pediatric capability level, defined by which of 24 services were provided (level 1: broadest range; level 4: minimal services).

A mean of 3,927 hospitals were analyzed per year; in 2022, 67.3, 39.7, 47.0, and 37.4 percent were nonprofit, urban teaching, small, and in the South, respectively. The researchers found that over time, there was a decrease in the number of high-capability hospitals. After adjustment for hospital characteristics, there were decreases in level 1, 2, and 3 hospitals (38, 54, and 48 percent, respectively) and an increase of 137 percent in level 4 hospitals. Fewer hospitals were capable in 2022 than 2003 for 17 of 24 capabilities (71 percent). The steepest declines for hospital-level specific services were seen for moderate-intensity services, including appendectomy, pneumonia hospitalization, and asthma hospitalization (−50.5, −42.3, and −41.1 percent, respectively). Extracorporeal oxygenation, organ transplant, and Fontan surgery had the smallest changes (+0.8, 0.0, and −0.1 percent, respectively).

“Fewer hospitals provide a range of pediatric services to children, limiting national capacity to provide pediatric hospital care across a range of conditions and complexity,” the authors write.

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