Effectiveness of Pediatric Concurrent Hospice Care to Improve Continuity of Care.
Lisa C Lindley, Melanie J Cozad, Jennifer W Mack and 3 others
PMID 34866426WHAT IT FOUND
Children receiving concurrent hospice care stayed in hospice significantly longer and disenrolled less often than those in standard care.
However, they were more likely to transition to the emergency room or inpatient care, suggesting these medical moves are part of the blended care model rather than a failure of hospice.
Key findings
01Concurrent hospice care was associated with significantly longer hospice stays and reduced disenrollment compared to standard care.
02Children in concurrent care had twice the odds of emergency room use and higher odds of inpatient transitions compared to standard care.
03The study used an instrumental variable analysis on Medicaid claims data to compare outcomes for pediatric decedents.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study relies on Medicaid claims data, so the findings may not generalize to children with private insurance. The data covers 2011-2013, and family or provider attitudes toward concurrent care may have shifted since then. The dataset contained no information on family perspectives or satisfaction, which are key drivers in the decision to use concurrent care. The study could not determine who authorized the emergency or inpatient transitions (e.g., hospice team vs. treating physician).
The easy way to misread this
Do not interpret the higher rates of emergency room and inpatient use as evidence that concurrent hospice care is less effective at keeping children at home or in hospice settings. These transitions were likely authorized by the treating medical team for disease management, which is permitted under concurrent care, rather than representing a crisis or failure of hospice support.