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Nearly one in eight children undergoing a common inpatient surgical procedure lived more than 60 miles (97 kilometers) from the hospital where they received care. These children had higher odds of complications, longer hospital stays and higher hospital charges than children who lived closer, according to a study published in the Journal of the American College of Surgeons (JACS).

The findings come as pediatric surgical care becomes increasingly concentrated at larger hospitals and specialized children's hospitals, requiring some families to travel far even for common procedures.

Using 2018–2021 inpatient data from 12 states, researchers analyzed 71,451 children who underwent an appendectomy, gallbladder removal, surgery for pyloric stenosis, inguinal hernia repair or feeding tube placement. Of these children, 8,594 (12%) lived more than 60 miles (97 kilometers) from the treating hospital.

Compared with children who lived less than 30 miles (48 kilometers) from the hospital, those who lived more than 60 miles (97 kilometers) away had:

Children who lived 30 to 60 miles (48 to 97 kilometers) away had hospital stays and charges that were each about 4% higher than those of children living less than 30 miles (48 kilometers) away.

Children who lived more than 60 miles (97 kilometers) from the hospital were also younger than those living less than 30 miles (48 kilometers) away (median age 3 versus 10 years), more likely to live in rural areas (47% versus 5%) and more likely to have been transferred for care (39% versus 13%).

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