A new study from Vanderbilt University Medical Center researchers provides the first national atlas of pediatric acute care. The atlas has significant potential to benefit public health, from disaster or pandemic response to evaluations of quality, costs and value of care to strategy for health systems, researchers say.
The study, recently published in JAMA Pediatrics, draws on more than 28 million acute care encounters to map out pediatric hospital service areas across the U.S. These regions show how far pediatric patients typically travel from home to receive emergency department and inpatient care. The researchers then used these service areas to chart an additional atlas of pediatric referral regions, which captures patient referrals between hospitals.
In total, 835 pediatric service areas and 105 interhospital referral regions were defined using zip codes, geolocations of acute care hospitals, and other measures of patient travel.
The atlas is the result of a multiyear collaboration between VUMC’s Center for Health Economic Modeling and researchers at Ann & Robert H. Lurie Children’s Hospital of Chicago, Dell Medical School at the University of Texas at Austin, University of Colorado, and Children’s Hospital Colorado.
The study was led by Kenneth Michelson, MD, MPH, at Lurie Children’s, with collaboration from John Graves, PhD, professor of Health Policy and Medicine at VUMC, and director of the Center for Health Economic Modeling. The study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, part of the National Institutes of Health.
“A few years back, VUMC’s Center for Health Economic Modeling developed and published an open-source methodological tool kit for how to apply modern network analysis methods to define the boundaries of health care service areas and markets,” said Graves. “This methodological foundation has now facilitated a series of high-impact collaborations to better understand how patients move through the U.S. health care system.”
The referral atlas could be beneficial in areas where there are multiple pediatric acute care hospitals in enabling more accurate measurements and benchmarking of quality of care, costs and outcomes within and across regions, which could drive policy and quality improvement interventions to improve the well-being and outcomes of pediatric patients. By identifying well-defined regions within which most pediatric travel patterns occur, the atlas can also help health systems strategize coordination of care or crisis response.
“This is exactly the type of collaboration the Center was set up to support — rigorous, methodologically founded research that can inform strategy, performance measurement and policymaking with broad appeal,” Graves said.