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September 1983

Secondary Care: The Role of the Community Hospital in Pediatrics

Author Affiliations

From the Department of Pediatrics, Sinai Hospital of Baltimore.

Am J Dis Child. 1983;137(9):902-906. doi:10.1001/archpedi.1983.02140350076019

In this George Armstrong address I should like to consider the role of the community hospital in the care of children. This subject properly belongs under what might be defined as secondary care, a term that requires further clarification itself. Why is this question of interest? For several reasons: First, there are a large number of community hospitals in this country—just under 6,000—many of them built with Hill-Burton funds in the years after World War II. That rapid construction phase has ended, but has left us with an abundance (some would say an excess) of institutions, well distributed relative to where people live. Second, a great quantity and variety of medical services for children are provided in these hospitals—not only secondary care, but primary and tertiary care as well—and that will continue to be the case in the future. Third, there is reason to question whether the quality of that