A National Profile of Children Receiving Pediatric Concurrent Hospice Care, 2011 to 2013.
Lisa C Lindley, Melanie J Cozad, Radion Svynarenko and 2 others
PMID 33911058WHAT IT FOUND
Children receiving concurrent hospice care were medically complex and moved often between settings: they averaged 20 hospice discharges and re-enrollments, and a third had only a one-day hospice stay.
Nurses should expect frequent care transitions and coordination.
Key findings
01More than half of children (56.4%) had a complex chronic condition, and 39% had multiple complex chronic conditions.
02Children discharged and re-enrolled in hospice care on average 20 times, and a third had a 1-day hospice admission.
03Almost 20% of children in concurrent care transitioned out of hospice to use the emergency room, and 11% transitioned for inpatient care.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was limited to children enrolled in Medicaid, although some also had private insurance. The data covered only 2011 to 2013, the first three years of the Affordable Care Act concurrent care period. The included children were those who used non-hospice medical services on the same day as hospice care, so this describes a subset of Medicaid hospice users. The design was descriptive, so it cannot show the effects of concurrent care or coordination methods. The findings may not apply outside the United States because concurrent care is a US Medicaid delivery model.
Declared interests
No conflicts of interest were declared. The publication types list NIH extramural research support.
The easy way to misread this
Do not read the high average of 20 hospice discharges and re-enrollments and the acute care transitions as evidence that concurrent hospice care worsens outcomes or that hospice nurses caused them. This was a descriptive claims analysis with no comparison group, so it cannot show whether concurrent care or coordination affected children or families.