Why and How Has Been the Pediatric Surgery Network in Midi-Pyrénées Created and Then Evaluated?

After a study from the CNAM (National health insurance fund) about pediatric surgery in Midi Pyrenees, it has been decided by ARS (Regional health agency) to set up a pediatric surgery network. There were 3 objectives: to promote local surgery service, to request safety by using appropriate care and facilities, and to aim at quality of care by defining the scope of work of each institution and helping with training. The specificities of pediatric medicine were defined in 3 different care facilities: local hospital, specialized hospital and referral hospital. After a survey undertaken in Midi-Pyrénées, 23/33 local hospitals, 4/5 specialized hospitals and 1/1 referral hospital were certified by the ARS. At 8 years follow up, the analysis of the records showed a decrease of surgical procedures performed in non-certified hospitals while the caseload in the local hospitals was maintained. Infants below 1 year of age were less operated on in local hospitals and the sphere of operation had been respected. These results are promising and encourages to enlarge the network.