Identifying Inpatient Pediatric Services Across National Datasets

Area of Science:

• Health Services Research
• Pediatric Health
• Data Science

Background:

• National statistics on pediatric hospital services vary due to differing data sources.
• Conflicting estimates hinder accurate assessment of pediatric service accessibility.
• Standardized data is crucial for understanding and improving pediatric care access.

Purpose of the Study:

• To evaluate the accuracy of pediatric inpatient service reporting in three national datasets.
• To explore machine learning models for enhancing pediatric service identification in merged datasets.
• To provide insights for optimizing pediatric service definitions in national health policy.

Main Methods:

• A cross-sectional study analyzed 3114 US hospitals using data from the American Hospital Association (AHA), Centers for Medicare & Medicaid Services Provider of Service File (POS), and National Pediatric Readiness Project (NPRP).
• Test characteristics (F1 scores) were calculated for four pediatric services: newborn, neonatal intensive care, general pediatric inpatient, and pediatric intensive care.
• Logistic regression, random forest, gradient-boosted trees, and rule-based models were tested on a merged dataset to improve service identification.

Main Results:

• The National Pediatric Readiness Project (NPRP) identified varying percentages of hospitals providing specific pediatric services.
• Agreement between AHA/POS data and NPRP varied by service; AHA showed higher agreement for newborn and pediatric intensive care, while POS showed higher agreement for general pediatric care.
• Merging datasets demonstrated a modest improvement in the accuracy of identifying pediatric services.

Conclusions:

• Significant discrepancies exist in reporting pediatric services across commonly used national datasets.
• These findings highlight the need for standardized definitions and improved data quality for pediatric health services.
• The study's results can inform strategies to optimize service line definitions and enhance pediatric health care policy.