Pediatric Primary Care Involvement in End-of-Life Care for Children.
Lisa C Lindley, Savithri Nageswaran
PMID 26430133WHAT IT FOUND
Pediatric primary care involvement was not linked to hospice use overall.
It was linked to home health care use, and to hospice use for children 15 to 20 years.
Key findings
01Among 2,037 pediatric decedents, 216 (10.6%) used hospice and 460 (22.6%) used home health care before death.
02For all children, primary care involvement was not linked to hospice use but was linked to home health use after adjusting for other factors.
03For children 15 to 20 years, the odds of using hospice were 4 times higher with usual source of care and with low, moderate, or high continuous care.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The sample included only California fee-for-service Medicaid beneficiaries, so the results may not apply to managed care Medicaid beneficiaries or children outside California. The analysis used only the last calendar year of life, not a comprehensive claims history. The measures of primary care involvement may not have captured all aspects of usual source, comprehensive, or continuous care. The study could not determine whether referrals were made by primary care, specialist, or palliative care providers, nor whether specialist or palliative care influenced service use. The data did not identify the type of primary care provider, so provider scope of practice could not be tested.
Declared interests
The authors report no potential conflicts of interest to disclose.
The easy way to misread this
Do not read the higher hospice odds for children 15 to 20 years as proof that primary care involvement causes hospice use. The overall hospice relationship was null, and the study only analyzed claims associations.