Atlas of Pediatric Acute Care Shapefiles

The Atlas of Pediatric Acute Care encodes regions of common pediatric acute care utilization at two levels. Each region is composed of mutually exclusive sets of ZIP codes. These regions were generated from 2021-2022 Medicaid and Children's Health Insurance Program data. Pediatric emergency service areas (PESAs) are regions where children visit the same set of hospitals from home. Pediatric emergency referral regions (PERRs) are regions where children have common patterns of between-hospital referrals. This repository includes the shapefiles for PESAs, PERRs, and a ZIP-PESA-PERR crosswalk CSV file. CITATION: Michelson KA, Skol AD, Graves JA, Remick KE, McMullen PD, Singamsetty N, Cory DK, Bucholz EM. Development of an Atlas for US Pediatric Acute Care. JAMA Pediatr. 2025 Oct 27:e254227. doi: 10.1001/jamapediatrics.2025.4227. PMID: 41143815