All six acute care childrens hospitals in the state are located in HSAs showing high pediatric localization, and five are in HSAs with significant pediatric-Medicare localization divergence. The HSAs for California do not fit pediatric patient origin data as well as they do Medicare data. The strong positive correlation between pediatric and Medicare indices of localization suggest that, in lieu of more appropriate geographic units, the HSAs may be suitable for research into geographic variations in pediatric healthcare resources and utilization. However there is substantial room for improvement of 'fit' for pediatric data. Either children are traveling farther or are participating in a somewhat different inpatient care system.
More research is needed to determine if pediatric inpatient resources are optimally distributed.
A first step would be the development of HSAs based on pediatric discharge orgins.