Mental health and developmental disabilities in US children admitted in hospice care.
Lisa C Lindley, Radion Svynarenko, Lora Humphrey Beebe
PMID 34038179WHAT IT FOUND
Documented diagnoses in 6,195 pediatric hospice Medicaid records included behavioral disorders (28.50%), anxiety (16.4%), depression (12.8%), and developmental delay in almost half (48.1%).
Older adolescents had more anxiety and depression; infants had more developmental delays.
Key findings
01In the sample, behavioral disorders were the most common mental health diagnosis (28.50%), followed by anxiety (16.4%), affective disorders (14.2%), and depression (12.8%).
02Almost half had developmental delay (48.1%), with the highest proportion in children under 1 year (79.3%); intellectual disability was most common in the 15 to 20 years group (15.5%), and other developmental disabilities were highest in the 6 to 14 years group (41.3%).
03Children aged 15 to 20 years predominately experienced anxiety (30.9%), depression (33.1%), and affective disorders (34.8%) compared with those 14 years and younger.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was limited to children admitted to Medicaid and hospice at end of life, so the findings may not apply to children without Medicaid or without hospice care. Only children with a documented mental health or developmental disability diagnosis and service-level claims were retained, so the percentages do not describe all children entering hospice. Infants may be underrepresented because serious disease can develop quickly and Medicaid enrollment can take several months. The data were administrative claims, not clinical assessments, and lacked context such as family history, family characteristics, and psychological assessment results. Categories with less than 10% or 10 observations were not reported, so some smaller groups are not shown.
Declared interests
None declared.
The easy way to misread this
Do not read these percentages as the true prevalence for all children entering hospice. The analysis included only children with documented mental health or developmental disability diagnoses and Medicaid claims, and it used administrative diagnosis codes rather than clinical assessment.