Pediatric surgeries often performed in general hospitals

(HealthDay)—The volume of general pediatric surgery performed in the United States is high, and these procedures are divided between specialized pediatric institutions and general hospitals, according to a study published online Nov. 25 in Pediatrics.

Stig Sømme, M.D., from the Children's Hospital Colorado in Aurora, and colleagues used International Classification of Diseases, Ninth Revision, Clinical Modification codes from the 2009 Kids' Inpatient Database (patients <18 years old) to calculate surgical frequencies by hospital type (free-standing children's hospital, children's unit within an adult hospital, and general hospital) and geographic region.

The researchers found that of the 216,081 procedures for 2009, the top 20 procedures accounted for more than 90 percent of cases. About 40 percent of pediatric inpatient surgical procedures took place in adult general hospitals. Infrequent complex low-volume neonatal surgical procedures, including pullthrough for Hirschsprung disease, surgery for malrotation, esophageal atresia repair, and diaphragmatic hernia repair, were 6.8 to 16 times more likely to happen in a children's hospital. For appendectomy and cholecystectomy, there was significant regional variation in frequency rates.

"Such data may influence the distribution of pediatric surgeons, number of trainees, and training curricula for pediatric surgeons, pediatricians, general surgeons and other surgical specialists who might operate on children," the authors write.

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