Children who travel farther for common surgery face more complications and longer hospital stays than local patients, according to a news release.
Routine pediatric surgery continues to shift toward larger hospitals and specialized children’s hospitals. An earlier Child Health Evaluation of Surgical Services analysis of 143,467 children undergoing seven common procedures from 2002 to 2017 found that travel distance rose more steeply for rural than urban children, according to a report published in the Annals of Surgery.
Rural residence, age younger than 5 years, and Medicaid coverage were each associated with traveling more than 60 miles. The Journal of the American College of Surgeons study published on November 10, 2026, notes that the farthest-traveling cohort differed at baseline as these children were younger at a median age of 3 versus 10 years, more often rural at 47% versus 5%, and more often transferred from another facility at 39% versus 13%.
Longer Travel Distances Increase Risks of Serious Postoperative Adverse Events
Single-center data point the same way. Patients living more than 120 minutes away at a quaternary pediatric surgical center with a large rural catchment area had higher unadjusted odds of serious postoperative adverse events than those within 60 miles, according to the American Journal of Surgery.
Cornelia L. Griggs emphasized the financial strain on traveling families, particularly when parents lose work time or need care for siblings at home. “The data could inform questions about the pediatric surgical workforce and where hospitals should offer services,” she told Contemporary Pediatrics.
While certain pediatric patients can receive care securely near their residences, others gain advantages from being sent to a specialized facility, according to the study’s writers. Their recommendations included enhanced collaboration between local and regional medical facilities, well-defined guidelines for patient transfers, and assistance involving lodging, transit, or telemedicine when trips cannot be bypassed.
Administrative Database Limitations
The administrative database does not capture illness severity, surgical complexity, or pediatric services available at local hospitals. Excess complications among distant patients may reflect case mix rather than distance itself because children with complex needs may have been referred to specialized centers by design.
Distance was estimated from ZIP codes and may not reflect actual travel time. The investigators plan future studies examining travel time and patient complexity.
Common Questions on Distance and Surgery
Who travels the farthest for pediatric procedures?
The farthest-traveling cohort consists of children with a median age of 3 years who are more often from rural areas and frequently transferred from another facility.
What factors increase the odds of traveling over 60 miles?
Rural residence, age younger than 5 years, and Medicaid coverage each show a strong association with traveling more than 60 miles for surgical care.
How does distance affect postoperative adverse events?
Patients living more than 120 minutes away from a quaternary pediatric surgical center experience higher unadjusted odds of serious postoperative adverse events compared to those living within 60 minutes.