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The following is a summary of “Access to Pediatric Bed Capacity According to Social Determinants of Health: All Beds Are Not Created Equal,” published in the December 2024 issue of Pediatrics by Hegland et al.     

Pediatric patients’ social determinants of health (SDoH), including family income, racial and ethnic composition, and community opportunity, influence access to health care and outcomes.  

Researchers conducted a retrospective study to evaluate pediatric inpatient hospital capacity and resource allocation disparities based on SDoH.  

They analyzed cross-sectional data from the Healthcare Cost and Utilization Project (HCUP) and American Hospital Association (AHA) surveys. The data included non-elective inpatient discharges (for children and adolescents aged ≥1 month to ≤19 years) from 1,404 hospitals in the U.S. that had at least 1 pediatric bed and 1 pediatric discharge, SDoH were derived from the American Community Survey (ACS) measures and the Child Opportunity Index (COI). Hospital resources were evaluated using data on discharges, capital, expenditure, staffing, transfer rates, payer mix, and central line-associated bloodstream infection (CLABSI) rates.  

The results showed a mean pediatric bed capacity of 3.26 per 10,000 children and adolescents (95% CI: 3.24-3.29). Although bed capacity was consistent across racial and ethnic groups, hospitals serving children and adolescents from socially disadvantaged communities (those with low income, low COI, or located in rural areas) had fewer resources, higher transfer rates, and served a greater proportion of children and adolescents enrolled in Medicaid. Hospitals in communities with very high COI scores had $284,000 greater expenditure per bed compared to those in communities with very low COI scores and served 16% fewer children and adolescents enrolled in Medicaid. Adjusted CLABSI rates showed no substantial differences based on SDoH.  

They concluded that while pediatric bed capacity was evenly distributed, hospitals serving children and adolescents from disadvantaged communities had fewer resources and lower capabilities, underscoring the need for equity-focused resource allocation strategies.  

Source: jpeds.com/article/S0022-3476(24)00550-X/abstract