The evolution of Shriners Hospitals for Children in North America

Shriners Hospitals for Children have been providing totally free care to children with neuromusculoskeletal disabilities since 1922. This mission expanded in 1962 to include the care of children with burn injuries and expanded in 1978 to include children with spinal cord injuries. Today, Shriners Hospitals for Children include 19 hospitals that provide pediatric orthopaedic care, four hospitals that provide acute and reconstructive burn care, and three hospitals in which spinal cord injury rehabilitation centers are located. During the past 20 years, case acuity and complexity have increased, comprehensiveness of care has been emphasized, members of the medical staff have increasingly become full-time, and sponsored intramural research has increased to a budget of $22 million annually. Annually, more than 250 orthopaedic residents receive pediatric orthopaedic training and more than 150 surgical residents are trained in pediatric burn care in Shriners Hospitals. In 1998, approximately 25,000 children were admitted for care, more than 22,000 operations were performed, and 236,000 children were treated as outpatients. In 1999, the annual operating budget for Shriners Hospitals for Children was $397 million.