Aspects and Intensity of Pediatric Palliative Case Management Provided by a Hospital-Based Case Management Team: A Comparative Study Between Children With Malignant and Nonmalignant Disease.
Charissa T Jagt-van Kampen, Derk A Colenbrander, Diederik K Bosman and 3 others
PMID 28273758WHAT IT FOUND
Children with malignant disease received more intensive daily support (median 28.9 minutes) for shorter periods, while those with nonmalignant disease received less daily support (median 15.8 minutes) but over longer durations and with more hospital days.
Key findings
01Patients with malignant disease received significantly more minutes of case management per day (median 28.9) than those with nonmalignant disease (median 15.8).
02Patients with nonmalignant disease had significantly more total hospital admission days (median 353 days total for the group) compared to those with malignant disease (median 121 days total for the group).
03The primary reasons for hospital admission differed: anticancer therapy for malignant cases and infections for nonmalignant cases.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study cohort is small (43 patients), limiting the generalizability of the findings. The study was conducted in a single center in the Netherlands, so results may not apply to other healthcare systems. The design is retrospective and observational, so it describes patterns of care rather than proving the effectiveness of the intervention. There may be inclusion bias, as patients with long-term admissions (often NMD) might have been more likely to be referred to the team.
Declared interests
The authors declared no potential conflicts of interest. The research was supported by funding from Agis and KIKA.
The easy way to misread this
Do not interpret the higher daily minutes for malignant disease patients as a sign of better care or higher need in absolute terms. The difference reflects the nature of the diseases: malignant cases often involve rapid, intensive terminal phases requiring frequent coordination, while nonmalignant cases involve chronic, long-term management with fewer daily interventions but more total hospital days.