SURGERY: Edited by Nikunj K. ChokshiThe economics of a pediatric surgical ICUSlater, Bethany J.a; Vogel, Adam M.bAuthor Information aUniversity of Chicago Medicine, Chicago, Illinois bSurgery and Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA Correspondence to Bethany J. Slater, MD, MBA, University of Chicago Medicine, 5841 S. Maryland Avenue, Chicago, IL 60637, USA. Tel: +1 773 702 6175; fax: +1 773 702 1192; e-mail: email@example.com Current Opinion in Pediatrics: June 2020 - Volume 32 - Issue 3 - p 424-427 doi: 10.1097/MOP.0000000000000893 Buy Metrics Abstract Purpose of review The purpose of this review is to describe quality and financial economic principles that form the foundation for complex care delivery systems for the critically ill pediatric surgical population. Recent findings Advances in neonatology along with innovation in surgical techniques in children led to the need to care for more complex postoperative surgical patients. Several studies have demonstrated improved outcomes in specialized pediatric centers. Furthermore, there is some evidence to suggest that there is overall financial benefit with decreased costs and more efficient resource use to pediatric subspecialty critical care. Summary As more becomes known regarding the impact of specialized ICU environments, pediatric surgical critical care, and pediatric surgical ICUs have the potential to improve the value of care delivered to these complex patients. Well-designed, prospective, observational studies are needed to assist in defining appropriate outcome and quality measures to inform the development of these specialized units. Currently, there are a variety of models used in children's hospitals to care for critically ill surgical patients. This represents a tremendous opportunity for a collaborative, multidisciplinary effort amongst pediatric medical and surgical intensivists. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.