Challenges in Geographic Access to Specialized Pediatric Burn Care in the United States

Geographical access to pediatric burn centers in the United States is not well described. Patients may receive care at American Burn Association (ABA)-verified burn centers, unverified burn centers, or nonburn centers. A recent study indicated that most US counties do not have an ABA-verified pediatric burn center within 100 miles. However, access to unverified burn centers that provide care to pediatric burn patients was not considered. We studied access to all pediatric burn centers across different US regions, using American College of Surgeons (ACS) Committee on Trauma-verified pediatric trauma centers as a benchmark.

An observational cohort study was conducted using 2022 US Census data. Individuals aged ≤14 years were included. Geographical location was determined by residence ZIP code. Pediatric burn centers were identified from the ABA directory. Pediatric trauma centers were identified by ACS verification status using the ACS Hospitals and Facilities directory. Population access to pediatric burn and trauma centers within 50, 100, and 300 miles of the home ZIP code was assessed.

Of US children, 62.1%, 83.5%, and 98.6% live within 50, 100, and 300 miles of a pediatric burn center. Access to ABA-verified pediatric burn centers is lower compared to access to ACS-verified pediatric trauma centers.

Overall, the US population has limited access to pediatric burn centers compared to pediatric trauma centers. The services offered and outcomes should be studied to better understand differences in the quality of care provided by verified and unverified centers.