Study: Hospital mergers add to inpatient pediatric services decline



(The Center Square) – New research suggests hospital mergers are contributing to a decline in inpatient pediatric services across the country, a symptom of a broader trend of consolidations reducing health care access.

A study published this week in JAMA Pediatrics highlighted increasingly centralized pediatric services in recent decades, due in part to closures among small rural hospitals, and explored the nexus between the two. The publication is a monthly peer-reviewed medical journal published by the American Medical Association.

Researchers at the University of Pittsburgh School Of Medicine gathered data on general and pediatric hospitals across the country from annual surveys by the American Hospital Association between 2011 and 2020.

The assessment of 5,104 hospitals found the share providing inpatient pediatric services declined from 41.5% to 32.6% over the decade. Primary analysis of 1,088 hospitals showed 235, or 21.6%, joined a hospital system between 2011 and 2020.

“Hospital consolidation, as measured by newly reported membership in a health system, was associated with closure of existing inpatient pediatric services within five years, potentially exacerbating this trend,” researchers wrote. “These findings are limited by the nature of a survey-based dataset, which is vulnerable to non-response bias, though the response rate for this survey is annually quite high. Future research should explore how inpatient unit closures are affecting observed access to pediatric acute care, particularly in the context of known geographic variation in access.”

The research is the latest of several studies that conflict on the impact hospital mergers have on patient outcomes, costs and access. A 2021 study from the Agency for Healthcare Research and Quality found decreases in mortality rates for heart failure, stroke, and pneumonia at rural hospitals after mergers.

Other research cited by American’s Health Insurance Plans shows mergers hurt hospital competition, leading to higher prices and “modestly worse patient experiences, while “process measures of quality were inconclusive.”

The increased patient costs and reduced access to care from hospital mergers, particularly in rural areas, is an issue North Carolina Treasurer Dale Folwell has repeatedly highlighted since taking office in 2017. Folwell, a Republican candidate for governor, pointed to the recent study in JAMA Pediatrics as evidence the state should do more to vet mergers to protect patients and taxpayers from the consequences.

“The peer-reviewed report just published in the Journal of the American Medical Association is more evidence of what we’ve been saying for the past five years,” Folwell wrote in an email to The Center Square. “Hospital consolidation reduces access, increases costs, decreases quality and only adds to the bottom line of these corporations and their billions in profits.”

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