Does surgical subspecialty care come with a higher price?
OBJECTIVE
Pediatric surgical specialization has been occurring over the past few decades to improve the outcomes of pediatric surgical care. There is sparse data to support the benefit to children from these educational efforts of these dedicated individuals. This literature review focuses on recent studies and the data documenting improvement in pediatric surgical care.


RESULTS
Studies from the field of pediatric urology, pediatric general surgery and pediatric neurosurgery are cited. Studies compared outcome data: within a children's hospital between pediatric urology specialists and general urologist performing the same operation; within a healthcare system between pediatric general surgeons and adult general surgeons for appendectomies; population based data for pyloromyotomies performed by general surgeons and pediatric general surgeons; and finally a database study of specialty neurosurgeons and hospital factors affecting outcomes.


CONCLUSIONS
Each study documented better pediatric patient surgical outcomes under the care of a pediatric subspecialty trained surgeon regardless of discipline. Those studies that studied costs showed more cost effective care was delivered by pediatric subspecialized surgeons.
Snow
Brent W
BW
Section of Pediatric Urology, The University of Utah School of Medicine, Salt Lake City, Utah 84112, USA. brent.snow@hsc.utah.edu
D002648:Child; D003362:Cost-Benefit Analysis; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000191:economics*; D010372:Pediatrics / Q000191:economics; D013038:Specialization; D013043:Specialties, Surgical / Q000191:economics; D013514:Surgical Procedures, Operative / Q000191:economics*