Impact of Locum Tenens Providers on Delivery of Pediatric Surgical Care.

Introduction: We sought to understand the impact of locum tenens surgeons on pediatric surgical care delivery.

Methods: We conducted a cross-sectional survey of Children's Hospital Association pediatric surgical practices. Anonymous electronic surveys were used to investigate locum tenens utilization, primary reason for use, limitations on clinical activities, and variations in practice standards or quality.

Accountable Care Organizations, Child Opportunity Index, and Complicated Appendicitis in Children.

Introduction: Child Opportunity Index (COI) is associated with complicated appendicitis (CA) in children. Value-based care through an accountable care organization (ACO) may modify this association. We aimed to determine if enrollment in our state's ACO, Partners For Kids (PFK), modified the association between COI and CA.

Missed Opportunity for Initial Diagnosis in Children With Complex Appendicitis.

Objectives: Delayed diagnosis of acute appendicitis in children may result in complex appendicitis with appendiceal perforation. Delayed diagnosis can result from missed opportunity for initial diagnosis (MOID) despite medical attention. Studies report MOID of less than 5% in pediatric emergency departments (EDs), but we hypothesized that many MOID occurs outside tertiary care facilities.

Regional Anesthesia and Surgical Volume in Children Undergoing Nuss Repair: A Multicenter Review.

Introduction: Regional anesthetic approach and surgical volume have been shown to outcomes in patients undergoing Nuss procedure for pectus excavatum. However, their independent relationship is not described. We investigated how regional anesthesia and surgical volume are associated with length of stay (LOS), postoperative opioid use, operating room utilization, and complications.

Interfacility Transfer of Children With Time-Sensitive Surgical Conditions, 2002-2017.

Importance: Surgical care for children in the United States has become increasingly regionalized among fewer centers over time. The degree to which regionalization may be associated with access to urgent surgical care for time-sensitive conditions is not clear.

Objective: To investigate whether transfers and travel distance have increased for 4 surgical conditions, and whether changes in transfers and travel distance have been more pronounced for rural vs urban children.