Patterns of Health Care Services During Pediatric Concurrent Hospice Care: A National Study.
Lisa C Lindley, Radion Svynarenko, Kim Mooney-Doyle and 3 others
PMID 34032124WHAT IT FOUND
Children in concurrent hospice were classified into low, moderate, and high service-use groups.
Most (61.1%) were low intensity, likely to use mainly medications, physician services, and labs. High-intensity children were often rural, with neurological/muscular conditions and technology dependence.
Key findings
01Children in pediatric concurrent hospice care were grouped into low, moderate, and high intensity service-use classes, and 61.1% were in the low intensity class.
02The high intensity class had high likelihood of medications, physician services, laboratory/x-ray services, durable medical equipment, outpatient hospital services, and inpatient hospital services, but low likelihood of physical therapy/occupational therapy/speech therapy services (10%).
03The high intensity class was predominately 1 to 5 years, male, other races, and non-Hispanic, and had high rates of neurological/muscular conditions, comorbidities, mental/behavioral health conditions, and technology dependence, with common rural residence in the South.
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 from 2011 to 2013, so results may not apply to children with private insurance or Tricare, or to care outside the United States. The sample was restricted to 6,243 children who used at least one health care service on the same day as hospice care, out of 21,383 children enrolled in the Medicaid hospice benefit. The data are administrative claims, so the study could not examine the role of the physician, location of service, or specific services provided. The study was designed to describe patterns of service use, not to test whether services improved outcomes. Latent class model fit was not definitive: the Lo-Mendell-Rubin probability did not provide strong evidence of class fit, and there is no single definitive goodness-of-fit statistic for this method.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not read these clusters as evidence that any service, including physical therapy, occupational therapy, speech therapy, home health, or inpatient hospital care, improved outcomes or was medically necessary. The study used Medicaid claims data to describe patterns of service use; it did not compare treatment groups or measure patient outcomes.