Temporal Trends in Geographic Distribution of PICUs in the United States 2001–2023

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Between 2001 and 2023, Pediatric Intensive Care Units (PICUs) in the United States remained highly concentrated in urban areas, resulting in persistent geographic inequities in access to care for children in rural and western regions. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Eleanor Gradidge; Abigail Shih; K. Samson; Christina Cifra; Robin Klein; Adrienne G. Randolph

doi:10.1097/pcc.0000000000004022

August 26, 2026Pediatric Critical Care Medicine

Temporal Trends in Geographic Distribution of PICUs in the United States 2001–2023

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Key Points

To identify and evaluate longitudinal changes in the geographic distribution and spatial accessibility of pediatric intensive care units across the United States from 2001 to 2023.
Conducted a cross-sectional spatial analysis evaluating three distinct time points (2001, 2016, and 2023).
Calculated straight-line distances from each U.S. census tract center to the nearest pediatric intensive care unit and stratified findings by census regions and divisions.
The median distance from census tract centers to the nearest pediatric intensive care unit rose from 12.5 miles (IQR, 4.5–37.1 miles) in 2001 to 12.8 miles (IQR, 4.9–36.2 miles) in 2016 and 13.3 miles (IQR, 5.2–36.0 miles) in 2023.
In 2023, regional median travel distances varied widely from 7.4 miles in the Middle Atlantic division to 30.1 miles in the East South Central division.
Across all study years, units remained concentrated in urban hubs, with Arkansas, Nebraska, and Oregon having units in only a single city and Wyoming having no pediatric intensive care units.

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Implication

Cross-sectional study reveals increasing distances to pediatric intensive care units across census tracts, highlighting persistent geographic disparities in critical care access.

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Cite This Study

Gradidge et al. (2026) studied this question.

synapsesocial.com/papers/6a91465ad15324a1df3a9ea2 https://doi.org/10.1097/pcc.0000000000004022

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Temporal Trends in Geographic Distribution of PICUs in the United States 2001–2023

Key Points

No abstract yet

Implication

Discussion

Cite This Study

Temporal Trends in Geographic Distribution of PICUs in the United States 2001–2023

Key Points

No abstract yet

Implication

Discussion

Cite This Study

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