Geographic Variation in California Pediatric Hospice Care for Children and Adolescents: 2007-2010.
Lisa C Lindley, Sheri L Edwards
PMID 27837156WHAT IT FOUND
In California Medicaid, 89.39% of children and adolescents who died with a life-limiting condition did not use hospice care.
Potential need was highest around Los Angeles, where thirty-six pediatric hospice providers were located.
Key findings
01In the study sample, 89.39% had potential need for hospice care, meaning they died with a life-limiting condition without using hospice, and 10.6% had realized need.
02The highest density of potential hospice need was found around Los Angeles, and thirty-six hospices supplied pediatric care there during the study timeframe.
03Realized hospice need was highest around Los Angeles and San Diego, with thirty-six providers in Los Angeles and three providers in San Diego.
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 California Medicaid claims data, so it may not apply to families with private insurance or Medicaid in other states. It looked only at the last calendar year of life and did not include a comprehensive claims history. The analysis was descriptive, so it cannot show why hospice was or was not used. It used zip-code centroids and hospice office locations, not individual addresses or measured travel time. It did not examine patient outcomes for children and adolescents at end of life.
The easy way to misread this
Do not read the map as proof that families chose not to use hospice or that providers failed them. The study describes where children who died without hospice lived and where providers were located. It cannot show why hospice was not used.