Health Services Research, Policy, and Access to Pediatric Surgical Care

Project start and end dates: 2012 – present

Background:
Children experience disparities in access to surgical and critical care based on geography, hospital resources, and policy decisions.

Objectives:

• Identify access barriers and outcome disparities
• Inform national policy and guideline development
• Improve ICU and surgical care delivery for children

Research Topics & Methods:

• Health services and policy research
• Large database and cohort analyses
• Guideline and consensus development

Implications:
This work informs AAP, ICN, and national pediatric surgical standards, particularly for rural and critically ill children.

Funders:

• Institutional (IHPI, CHEAR)
• Professional society-supported research

Collaborators:
AAP Section on Surgery, ICN, IHPI investigators, national policy stakeholders.

Key Publications:

• Gadepalli SK, Leraas HJ, Flynn-O'Brien KT, Van Arendonk KJ, Hall M, Tracy ET, Ricca RL, Goldin AB, Ehrlich PF. Changing Landscape of Routine Pediatric Surgery for Rural and Urban Children: A Report From the Child Health Evaluation of Surgical Services (CHESS) Group. Ann Surg. 2023 Oct 1;278(4):530-537. doi: 10.1097/SLA.0000000000005990. Epub 2023 Jul 27. PMID: 37497661.
• Van Arendonk KJ, Tracy ET, Ellison JS, Flynn-O'Brien KT, Gadepalli SK, Goldin AB, Hall M, Leraas HJ, Ricca RL, Ehrlich PF. Interfacility Transfer of Children With Time-Sensitive Surgical Conditions, 2002-2017. JAMA Netw Open. 2024 Oct 1;7(10):e2440251. doi: 10.1001/jamanetworkopen.2024.40251. PMID: 39418018; PMCID: PMC11581541.
• Tracy ET, Leraas HJ, Phillips MR, Van Arendonk KJ, Flynn-O'Brien KT, Padilla BE, Russell KW, Niba V, Gadepalli SK, Goldin AB, Hall M, Ehrlich PF. Characterizing the burden of care for children with solid tumors in the United States: A cross-sectional analysis from the Child Health Evaluation of Surgical Services Group. Cancer. 2026 Jan 1;132(1):e70193. doi: 10.1002/cncr.70193. PMID: 41411107.
• Hsu PJ, Khosrovaneh K, Kunnath N, Mullens CL, Ibrahim AM, Gadepalli SK. Neighborhood deprivation is associated with longer hospital stay for common pediatric surgical procedures independent of complication rates. Am J Surg. 2025 Dec 9;253:116773. doi: 10.1016/j.amjsurg.2025.116773. Epub ahead of print. PMID: 41478002.
• Mullens CL, Niba VS, Collins RA, Kunnath N, Newman EA, Ibrahim AM, Gadepalli SK. Quality of General Surgery Procedures in Children at Small Rural Hospitals. Ann Surg. 2025 Nov 13. doi: 10.1097/SLA.0000000000006981. Epub ahead of print. PMID: 41225697.