A National Study to Compare Effective Management of Constipation in Children Receiving Concurrent Versus Standard Hospice Care.
Lisa C Lindley, Jessica Keim-Malpass, Melanie J Cozad and 6 others
PMID 34840283WHAT IT FOUND
Children in concurrent hospice care were no more likely than children in standard hospice care to have constipation diagnosed or treated outside hospice.
Nurses should not expect concurrent care to add outside constipation management.
Key findings
01Children in concurrent hospice care were no more likely than children in standard hospice care to have constipation diagnosed or treated by a provider outside hospice.
02In the sample, 20% of children in concurrent care and 13% of children in standard care had constipation diagnosed or treated by a provider outside hospice.
03Complex chronic conditions, multiple complex chronic conditions, and mental/behavioral conditions were associated with constipation care outside hospice.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study measured only constipation care recorded outside hospice; hospice provider constipation care was included in the hospice per-diem rate and could not be assessed. Constipation was identified from administrative claims codes for diagnosis, treatment, surgery, enemas, and radiographs, which may miss mild constipation or prevention that does not generate these claims. The sample was limited to Medicaid hospice decedents, so the results may not apply to children with private insurance or TRICARE coverage. The study was observational and used a statistical method to approximate randomization, not a randomized trial. Children with missing dates or no service-level claims were excluded, so the final sample may not include all hospice-enrolled children.
Declared interests
The authors declared no conflicts of interest. The article is listed as NIH extramural research support.
The easy way to misread this
Do not conclude that hospice care fails to manage constipation or that concurrent care is worse. The study measured only constipation care recorded outside hospice, not care delivered by the hospice team, and the adjusted comparison found no significant difference.