Rural children struggle to access hospital services, say researchers

Children in rural areas were more than six times as likely to check into a hospital without pediatric services compared to children in urban areas, a new study found. The research will be presented at the Pediatric Academic Societies (PAS) 2024 Meeting, held May 2–6 in Toronto.

Researchers studied approximately 80,000 hospital claims for nearly 37,000 children with multiple chronic conditions. The hospitalizations occurred between 2012 and 2017 in Colo., Mass., and N.H.

The study found that 41.9% of children in urban areas were first admitted to a children’s hospital for inpatient care, compared to 29.9% of children in rural areas. Nearly half of rural-residing children initially at a hospital without pediatric services were not transferred to a facility with pediatric services.

“Children with medical complexities living in rural areas are especially vulnerable when their nearest hospital closes,” said Seneca Freyleue, MS, research programmer and analyst at the Geisel School of Medicine at Dartmouth and presenting author.

“Expanding access to pediatric hospital services can help children with multiple chronic conditions receive care regardless of where they live.”

Despite the type of hospital the child initially visited, the percentage of children in rural areas who died in a hospital wasn’t significantly higher than their urban peers after adjusting for specific disease criteria, researchers concluded.

The results highlight the vital role small rural hospitals play in caring for an at-risk pediatric population, study authors said.