Who should do the operation? Where should the operation be done? After ensuring that their child needs a surgical procedure, these are among the most important questions anxious parents ask. Although factors such as travel distance and insurance requirements play a role in these decisions, the most important consideration is what will be safest and provide the best possible outcome. In this edition of Pediatrics, Somme and colleagues give us a view of the current landscape. This view is essential because it is hard to reach a destination if you do not know where you are.

Somme et al describe inpatient pediatric surgical case volumes from the Kids Inpatient Database (KID) from 2009. This includes 216 081 procedures performed in children <18 years at either a general hospital or pediatric hospital. The first important observation is that 40% of these operations occurred in general, not pediatric, hospitals. Although...

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