title: Pediatric surgeons' attitudes toward regionalization of neonatal surgical care.
abstract: OBJECTIVE
  Research has suggested that high-risk pediatric surgical patients have better outcomes when treated in resource-rich children's environments. Surgical neonates are a particularly high-risk population and some suggest that regionalization might be a strategy to improve clinical outcomes in neonatal surgical patients. We conducted a national survey of pediatric surgeons in the United States to explore their attitudes toward regionalization of neonatal surgical care.
  
  
  METHODS
  Members of the American Pediatric Surgical Association were asked to participate in an anonymous online survey to assess both attitudes toward regionalization, as well as perceptions of the importance of various resources in providing optimal care for surgical neonates.
  
  
  RESULTS
  Overall, 56.2% of participants favored regionalization. Surgeons whose practice was part of a training program tended to favor regionalization more, as did those from larger group practices and those who practiced at free-standing children's hospital. In addition, surgeons from larger groups and those involved with training programs more strongly favored the premise that a higher level of resource commitment should be available to treat surgical neonates.
  
  
  CONCLUSIONS
  The impact of any national strategy to improve neonatal surgical outcomes will be large and multi-faceted. While the majority of pediatric surgeons favor regionalization, our findings demonstrate variation in this view and highlight the necessity for surgeon involvement and education that will be critical in this effort.
authors.affiliation: Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Stephanie K
authors.initials: SK
authors.lastname: Bezner
authors.affiliation: Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Ira H
authors.initials: IH
authors.lastname: Bernstein
authors.affiliation: Department of Surgery, Children's Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Keith T
authors.initials: KT
authors.lastname: Oldham
authors.affiliation: Department of Surgery, University of Washington, Seattle, WA.
authors.forename: Adam B
authors.initials: AB
authors.lastname: Goldin
authors.affiliation: Department of Surgery, Oakland University William Beaumont School of Medicine, Royal Oak, MI.
authors.forename: Anne C
authors.initials: AC
authors.lastname: Fischer
authors.affiliation: Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: liernchen@gmail.com.
authors.forename: Li Ern
authors.initials: LE
authors.lastname: Chen
mesh_terms: D001291:Attitude of Health Personnel; D019538:Health Care Surveys; D006801:Humans; D007231:Infant, Newborn; D012041:Regional Medical Programs; D013514:Surgical Procedures, Operative / Q000592:standards*; D014481:United States
keywords: Neonatal surgery; Pediatric surgeons; Regionalization; Resources; Survey