End-of-Life Healthcare Service Needs Among Children With Neurological Conditions: A Latent Class Analysis.
Lisa C Lindley, Radion Svynarenko, Kim Mooney-Doyle and 3 others
PMID 34593722WHAT IT FOUND
Children with neurological conditions in concurrent hospice fell into two service-need groups.
The larger group needed mainly physician services and medicines. The smaller group needed hospital care, tests, medicines, and equipment.
Key findings
01Among 1,601 children with neurological conditions in concurrent hospice care, service use grouped into two patterns: 58% moderate intensity and 42% high intensity.
02The moderate intensity pattern was defined by high use of physician services and medications; the high intensity pattern included inpatient hospital, outpatient hospital, labs and x-rays, medications, and durable medical equipment.
03Among infants, 51% were in the moderate intensity class and 48.8% were in the high intensity class; all high-intensity infants had comorbidities and technology dependence.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used Medicaid claims only, so the service patterns may not apply to children with private insurance or Tricare. The claims data were pooled over three years and are from 2011 to 2013, so current service use may differ. The data show what was billed, not whether each service was clinically necessary or helpful. Therapy services were grouped together as one service category, so the study cannot describe physical therapy, occupational therapy, or speech therapy needs separately.
The easy way to misread this
Do not read the two service-need classes as proof that hospital, test, or equipment care improves outcomes. The study describes billed services for Medicaid children in concurrent hospice care, not whether the services helped or were clinically necessary.