A Comparison of Hospice Care Utilization Between Rural and Urban Children in Appalachia: A Geographic Information Systems Analysis.
Radion Svynarenko, Guoping Huang, Jessica Keim-Malpass and 5 others
PMID 37115718WHAT IT FOUND
Rural Appalachian children using hospice care had longer drive times to the nearest hospice than urban children in several states, but access varied widely and some states showed no difference.
Key findings
01The analysis included 1,788 children under 21 who used hospice care in Appalachian counties from 2011 to 2013.
02Drive times from the nearest hospice varied widely, averaging 28 minutes overall, with eastern Kentucky counties above 2 hours averaging 126 minutes and South Carolina averaging 11 minutes.
03Rural counties had longer drive times than urban counties in several states, including Tennessee and West Virginia, while some states showed no significant rural-urban difference.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The data are from 2011 to 2013 and may not reflect current hospice use. The analysis included only communities with children who already used hospice services, so some areas were missing. Drive times were based on county population centers and hospice locations, not exact patient addresses or staff homes. The study did not measure quality of care, symptom relief, or patient outcomes.
Declared interests
The authors reported no conflicts of interest. The study used Medicaid hospice claims collected by the Centers for Medicare and Medicaid Services.
The easy way to misread this
Do not conclude that longer drive times prove poor hospice quality or that telehospice would solve access. This study measured geographic drive times only and did not assess care quality or telehealth outcomes.