Differences in Characteristics of Dying Children Who Receive and Do Not Receive Palliative Care
- 1 July 2013
- journal article
- Published by American Academy of Pediatrics (AAP) in PEDIATRICS
- Vol. 132 (1), 72-78
- https://doi.org/10.1542/peds.2013-0470
Abstract
OBJECTIVE: Comparing demographic and clinical characteristics associated with receipt of palliative care (PC) among children who died in children’s hospitals to those who did not receive PC and understanding the trends in PC use. METHODS: This retrospective cohort study used the Pediatric Health Information System database. Children International Classification of Diseases, Ninth Revision code for PC. Diagnoses were grouped using major diagnostic codes. International Classification of Diseases codes and clinical transaction codes were used to evaluate all interventions. RESULTS: This study evaluated 24 342 children. Overall, 4% had coding for PC services. This increased from 1% to 8% over the study years. Increasing age was associated with greater receipt of PC. Children with the PC code had fewer median days in the hospital (17 vs 21), received fewer invasive interventions, and fewer died in the ICU (60% vs 80%). Receipt of PC also varied by major diagnostic codes, with the highest proportion found among children with neurologic disease. CONCLUSIONS: Most pediatric patients who died in a hospital did not have documented receipt of PC. Children receiving PC are different from those who do not in many ways, including receipt of fewer procedures. Receipt of PC has increased over time; however, it remains low, particularly among neonates and those with circulatory diseases.This publication has 17 references indexed in Scilit:
- Characteristics of Palliative Care Consultation Services in California HospitalsJournal of Palliative Medicine, 2012
- Whom are We Comforting? An Analysis of Comfort Medications Delivered to Dying NeonatesThe Journal of Pediatrics, 2011
- Pediatric Palliative Care Patients: A Prospective Multicenter Cohort StudyPEDIATRICS, 2011
- Palliative care consultation in pediatric oncologySupportive Care in Cancer, 2011
- AAHPM Position Paper: Requirements for the Successful Development of Academic Palliative Care ProgramsJournal of Pain and Symptom Management, 2010
- Easing of Suffering in Children With Cancer at the End of Life: Is Care Changing?Journal of Clinical Oncology, 2008
- The Growth of Palliative Care Programs in United States HospitalsJournal of Palliative Medicine, 2005
- Where Do Children With Complex Chronic Conditions Die? Patterns in Washington State, 1980–1998PEDIATRICS, 2002
- Palliative Care for ChildrenPEDIATRICS, 2000
- Symptoms and Suffering at the End of Life in Children with CancerThe New England Journal of Medicine, 2000