1
40
17
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Title
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August 2023 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
August List 2023
URL Address
<a href="http://doi.org/10.1111/jrh.12713" target="_blank" rel="noreferrer noopener"> http://doi.org/10.1111/jrh.12713</a>
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Title
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Incremental cost analysis of pediatric hospice care in rural and urban Appalachia
Publisher
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The Journal of Rural Health
Date
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2023
Subject
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Humans; Child; United States; Hospice Care; Patient Protection and Affordable Care Act; Costs and Cost Analysis; Hospices; Aged; Hospice Care; Medicare; Hospices; Appalachian Region
Creator
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Svynarenko R; Cozad MJ; Keim-Malpass J; Lindley LC
Description
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Purpose: Considering growing disparities in health outcomes between rural and urban areas of Appalachia, this study compared the incremental Medicaid costs of pediatric concurrent care (implemented by the Patient Protection and Affordable Care Act) versus standard hospice care. Methods: Data on 1,788 pediatric hospice patients, from the Appalachian region, collected between 2011 and 2013, were obtained from the Centers for Medicare and Medicaid Services. Incremental per-patient-per-month (PPM) costs of enrollment in concurrent versus standard hospice care were analyzed using multilevel generalized linear models. Increments for analysis were hospice length of stay (LOS). Results: For rural children enrolled in concurrent hospice care, the mean Medicaid cost of hospice care was $3,954 PPPM (95% CI: $3,223-$4,684) versus $1,933 PPPM (95% CI: $1,357-$2,509) for urban. For rural children enrolled in standard hospice care, the mean Medicaid cost was $2,889 PPPM (95% CI: $2,639-$3,139) versus $1,122 PPPM (95% CI: $980-$1,264) for urban. There were no statistically significant differences in Medicaid costs for LOS of 1 day. However, for LOS between 2 and 14 days, concurrent enrollment decreased total costs for urban children (IC = $-236.9 PPPM, 95% CI: $-421-$-53). For LOS of 15 days or more, concurrent care had higher costs compared to standard care, for both rural (IC = $1,399 PPPM, 95% CI: $92-$2,706) and urban children (IC = $1,867 PPPM, 95% CI: $1,172-$2,363). Conclusions: The findings revealed that Medicaid costs for concurrent hospice care were highest among children in rural Appalachia. Future research on factors of high costs of rural care is needed.
Identifier
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<a href="http://doi.org/10.1111/jrh.12713" target="_blank" rel="noreferrer noopener">10.1111/jrh.12713</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2023
Aged
Appalachian Region
August List 2048
Child
Costs And Cost Analysis
Cozad MJ
Hospice Care
Hospices
Humans
Keim-Malpass J
Lindley LC
Medicare
Patient Protection and Affordable Care Act
Svynarenko R
The Journal of Rural Health
United States
-
Dublin Core
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Title
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June 2023 List
Text
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June 2022 List
URL Address
<a href="https://journals.sagepub.com/doi/10.1177/10499091231173415">https://journals.sagepub.com/doi/10.1177/10499091231173415</a>
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Title
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A Comparison of Hospice Care Utilization Between Rural and Urban Children in Appalachia: A Geographic Information Systems Analysis
Publisher
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American Journal of Hospice and Palliative Care
Date
A point or period of time associated with an event in the lifecycle of the resource
2023
Subject
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Hospice Care; Hospices; Information Systems; pediatric hospice care; concurrent hospice care; medicaid; spatial analysis; ArcGIS; rural hospice care
Creator
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Svynarenko R; Huang G; Keim-Malpass J; Cozad MJ; Qualls KA; Stone Sharp W; Kirkland DA; Lindley LC
Rights
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
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<a href="https://journals.sagepub.com/doi/10.1177/10499091231173415">10.1177/10499091231173415</a>
2023
American Journal Of Hospice And Palliative Care
ArcGIS
concurrent hospice care
Cozad MJ
Hospice Care
Hospices
Huang G
Information Systems
June 2022 List
Keim-Malpass J
Kirkland DA
Lindley LC
Medicaid
Pediatric Hospice Care
Qualls KA
rural hospice care
spatial analysis
Stone Sharp W
Svynarenko R
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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July 2023 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
July List 2023
URL Address
<a href="http://doi.org/10.1177/01939459231163441" target="_blank" rel="noreferrer noopener"> http://doi.org/10.1177/01939459231163441</a>
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Application of Instrumental Variable Analysis in Pediatric End-of-Life Research: A Case Study
Publisher
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Western Journal of Nursing Research
Date
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2023
Subject
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Hospice Care; Terminal Care; Child; Death; Humans; Palliative Care; Patient Protection and Affordable Care Act; United States
Creator
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Svynarenko R; Cozad MJ; Mack JW; Keim-Malpass J; Hinds PS; Lindley LC
Description
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Instrumental variable analysis (IVA) has been widely used in many fields, including health care, to determine the comparative effectiveness of a treatment, intervention, or policy. However, its application in pediatric end-of-life care research has been limited. This article provides a brief overview of IVA and its assumptions. It illustrates the use of IVA by investigating the comparative effectiveness of concurrent versus standard hospice care for reducing 1-day hospice enrollments. Concurrent hospice care is a relatively recent type of care enabled by the Affordable Care Act in 2010 for children enrolled in the Medicaid program and allows for receiving life-prolonging medical treatment concurrently with hospice care. The IVA was conducted using observational data from 18,152 pediatric patients enrolled in hospice between 2011 and 2013. The results indicated that enrollment in concurrent hospice care reduced 1-day enrollment by 19.3%.
Identifier
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<a href="http://doi.org/10.1177/01939459231163441" target="_blank" rel="noreferrer noopener">10.1177/01939459231163441</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2023
Child
Cozad MJ
Death
Hinds PS
Hospice Care
Humans
July List 2023
Keim-Malpass J
Lindley LC
Mack JW
Palliative Care
Patient Protection and Affordable Care Act
Svynarenko R
Terminal Care
United States
Western Journal of Nursing Research
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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July 2023 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
July List 2023
URL Address
<a href="http://doi.org/" target="_blank" rel="noreferrer noopener"> http://doi.org/</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Evaluating the cost-effectiveness of pediatric concurrent versus standard hospice care
Publisher
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Nursing Economic$
Date
A point or period of time associated with an event in the lifecycle of the resource
2022
Subject
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Cost-Benefit Analysis; Hospice Care; Hospices
Creator
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Lindley LC; Cozad MJ; Svynarenko R; Keim-Malpass J; Mack JW; Hinds PS
Description
An account of the resource
Using a sample of 18,152 pediatric hospice patients, this study assessed the cost-effectiveness of concurrent care over standard hospice care. Analysis of incremental cost-effectiveness ratios with bootstrapping simulations showed that concurrent care was more effective but at a higher cost.
Identifier
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<a href="http://doi.org/" target="_blank" rel="noreferrer noopener"></a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2022
Cost-Benefit Analysis
Cozad MJ
Hinds PS
Hospice Care
Hospices
July List 2023
Keim-Malpass J
Lindley LC
Mack JW
Nursing Economic$
Svynarenko R
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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May 2023 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
May List 2023
URL Address
<a href="http://doi.org/10.1177/10499091231165276" target="_blank" rel="noreferrer noopener"> http://doi.org/10.1177/10499091231165276</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Geographic Information Systems Utilization in Pediatric End-of-Life Research: A Scoping Review
Publisher
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American Journal of Hospice and Palliative Care
Date
A point or period of time associated with an event in the lifecycle of the resource
2023
Subject
The topic of the resource
geographic information system; hospice care; palliative therapy; article; child; clinical practice; data visualization; Geographic Information Systems; human; Information Systems; software; systematic review
Creator
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Qualls KA; Svynarenko R; Cozad MJ; Keim-Malpass J; Huang G; Lindley LC
Description
An account of the resource
Currently, little is known about how geographic information systems (GIS) has been utilized to study end-of-life care in pediatric populations. The purpose of this review was to collect and examine the existing evidence on how GIS methods have been used in pediatric end-of-life research over the last 20 years. Scoping review method was used to summarize existing evidence and inform research methods and clinical practice was used. The Preferred Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA) was utilized. The search resulted in a final set of 17 articles. Most studies created maps for data visualization and used ArcGIS as the primary software for analysis. The scoping review revealed that GIS methodology has been limited to mapping, but that there is a significant opportunity to expand the use of this methodology for pediatric end-of-life care research.
Identifier
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<a href="http://doi.org/10.1177/10499091231165276" target="_blank" rel="noreferrer noopener">10.1177/10499091231165276</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2023
American Journal Of Hospice And Palliative Care
Article
Child
Clinical Practice
Cozad MJ
data visualization
geographic information system
Geographic Information Systems
Hospice Care
Huang G
Human
Information Systems
Keim-Malpass J
Lindley LC
May List 2023
Palliative Therapy
Qualls KA
Software
Svynarenko R
Systematic Review
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
March 2023 List
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
March List 2023
URL Address
<a href="http://doi.org/10.1097/njh.0000000000000918" target="_blank" rel="noreferrer noopener"> http://doi.org/10.1097/njh.0000000000000918</a>
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Title
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Conceptualizing the Value of Pediatric Concurrent Hospice Care
Publisher
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Journal of Hospice and Palliative Care
Date
A point or period of time associated with an event in the lifecycle of the resource
2023
Subject
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Hospice Care; Hospice; Child; Delivery of Health Care; Hospice Care; Hospice; Human
Creator
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Sharp WS; Svynarenko R; Fornehed MLC; Cozad MJ; Keim-Malpass J; Mack JW; Hinds PS; Mooney-Doyle K; Mendola A; Lindley LC
Description
An account of the resource
Given that pediatric concurrent hospice care has been available for more than a decade, it is appropriate to seek an understanding of the value of this care delivery approach. Value is the cost associated with achieving beneficial health outcomes. In pursuit of this goal, the current literature on pediatric concurrent hospice care was synthesized and used to develop a model to explain its value. Because of its relevance, the Value Assessment Framework was used to conceptualize the value of pediatric concurrent hospice care. This framework gauges the value of a health care service through 2 components: long-term effect and short-term affordability. The framework considers comparative clinical effectiveness, cost-effectiveness, other benefits or disadvantages, contextual considerations, and potential budget impact. Evidence from the literature suggested that the value of concurrent care depended on clinical outcomes evaluated, costs examined, medical services used, care coordinated, context considered, and budget impacted. The literature demonstrated that pediatric concurrent hospice care does offer significant value for children and their families. The conceptual model highlighted the need for a comprehensive approach to assessing value. The model is a useful framework for future research examining the value of concurrent hospice care.
Identifier
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<a href="http://doi.org/10.1097/njh.0000000000000918" target="_blank" rel="noreferrer noopener">10.1097/njh.0000000000000918</a>
Rights
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2023
Child
Cozad MJ
Delivery of Health Care
Fornehed MLC
Hinds PS
Hospice
Hospice Care
Human
Journal of Hospice and Palliative Care
Keim-Malpass J
Lindley LC
Mack JW
March List 2023
Mendola A
Mooney-Doyle K
Sharp WS
Svynarenko R
-
Dublin Core
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Title
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June 2022 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
June 2022 List
URL Address
<a href="http://doi.org/10.1177/10499091221089337" target="_blank" rel="noreferrer noopener">http://doi.org/10.1177/10499091221089337</a>
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Title
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Pediatric Concurrent Hospice Care: Cost Implications of a Hybrid Payment Model
Publisher
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American Journal of Hospice and Palliative Care
Date
A point or period of time associated with an event in the lifecycle of the resource
2022
Subject
The topic of the resource
Concurrent hospice care; Incremental cost analysis; Medicaid; Pediatric hospice care
Creator
An entity primarily responsible for making the resource
Cozad MJ; Svynarenko R; Hinds PS; Mack JW; Keim-Malpass J; Lindley LC
Description
An account of the resource
BACKGROUND: Implementation of concurrent hospice care led to a new hybrid payment model that combines hospice payments with payments for non-hospice medical care. Little is known about the cost implications of this new hybrid payment model. OBJECTIVE(S): The purpose was to identify costs and compare concurrent care and standard hospice care costs by estimating the average incremental Medicaid cost of care over time. METHOD(S): Using national Medicaid data of 18 147 hospice children and a multilevel generalized linear model, we calculated the incremental costs of receiving concurrent vs standard hospice care. We used the total cost of care over the last year of life. Increments for the analysis were hospice length of stay, stratified to 1 day, 2-14 days, and 15 + days. RESULT(S): Overall, compared to standard hospice care, enrollment in concurrent hospice care was significantly associated with an increase in outpatient care and prescription drug costs. For a stay of 1 day, concurrent hospice care decreased inpatient costs and increased costs of prescription drugs. For stays between 2 and 14 days, concurrent hospice decreased total costs and inpatient costs, but increased prescription drug costs. With a hospice stay of 15 + days, concurrent hospice had significantly higher costs across all measures, including total costs, inpatient costs, outpatient costs, and prescription drug costs. CONCLUSION(S): This study provides critical insight into incremental costs of receiving concurrent vs standard hospice care. More research is needed to understand how concurrent hospice lengthy hospice stays are associated with increases of costs.
Identifier
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<a href="http://doi.org/10.1177/10499091221089337" target="_blank" rel="noreferrer noopener">10.1177/10499091221089337</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2022
American Journal Of Hospice And Palliative Care
April 2022 List
concurrent hospice care
Cozad MJ
Hinds PS
Incremental cost analysis
Keim-Malpass J
Lindley LC
Mack JW
Medicaid
Pediatric Hospice Care
Svynarenko R
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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June 2022 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
June 2022 List
URL Address
<a href="http://doi.org/10.14423/SMJ.0000000000001365" target="_blank" rel="noreferrer noopener">http://doi.org/10.14423/SMJ.0000000000001365</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Comparison between Rural and Urban Appalachian Children in Hospice Care
Publisher
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Southern Medical Journal
Date
A point or period of time associated with an event in the lifecycle of the resource
2022
Subject
The topic of the resource
Appalachian Region; Child; Hospices; Medicaid; Retrospective Studies; Rural; Urban
Creator
An entity primarily responsible for making the resource
Fornehed MLC; Svynarenko R; Keim-Malpass J; Cozad MJ; Qualls KA; Stone WL; Lindley LC
Description
An account of the resource
Objective The goal of this study was to compare rural and urban pediatric hospice patients in Appalachia. Methods Using a retrospective, nonexperimental design, we sought to compare characteristics of Appalachian rural and urban children younger than 21 years enrolled in the Medicaid hospice benefit. Descriptive statistics were calculated on the demographic, hospice, and clinical characteristics of children from Appalachia. Comparisons were calculated using Pearson chi2 for proportions and the Student t test for means. Results Less than half of the 1788 Appalachian children admitted to hospice care resided in rural areas (40%). Compared with children in urban areas of Appalachia, rural children were significantly younger (8 years vs 9.5 years) and more often had a complex chronic condition (56.0% vs 35.1%) and comorbidities (38.5% vs 17.0%) with technology dependence (32.6% vs 17.0%). Children in rural Appalachian were commonly from communities in the southern region of Appalachia (27.9% vs <10.0%), with median household incomes <$50,000/year (96.7% vs 22.4%). Significant differences were present in clinical care between rural and urban Appalachian children. Rural children had longer lengths of stay in hospice care (38 days vs 11 days) and were less likely to use the emergency department during hospice admission (19.0% vs 43.0%). These children more often visited their primary care provider (49.9% vs 31.3%) and sought care for symptoms from nonhospice providers (18.1% vs 10.0%) while admitted to hospice. Conclusions Our results suggest that children admitted to hospice care in rural versus urban Appalachia have distinct characteristics. Rural children are admitted to hospice care with significant medical complexities and reside in areas of poverty. Hospice care for rural children suggests a continuity of care with longer hospice stays and fewer transitions to the emergency department; however, the potential for care fragmentation is present, with frequent visits to primary care and nonhospice providers for symptom management. Understanding the unique characteristics of children in Appalachia may be essential for advancing knowledge and care for these children at the end of life. Future research examining geographic variation in hospice care in Appalachia is warranted. Copyright © Lippincott Williams & Wilkins.
Identifier
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<a href="http://doi.org/10.14423/SMJ.0000000000001365" target="_blank" rel="noreferrer noopener">10.14423/SMJ.0000000000001365</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2022
Appalachian Region
April 2022 List
Child
Cozad MJ
Fornehed MLC
Hospices
Keim-Malpass J
Lindley LC
Medicaid
Qualls KA
Retrospective Studies
Rural
Southern Medical Journal
Stone WL
Svynarenko R
Urban
-
Dublin Core
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Title
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February 2022 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
February 2022 List
URL Address
<a href="http://doi.org/10.1177/10499091211064202" target="_blank" rel="noreferrer noopener">http://doi.org/10.1177/10499091211064202</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Pediatric End-of-Life Care in Rural America: A Systematic Review
Publisher
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American Journal of Hospice and Palliative Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2021
Subject
The topic of the resource
systematic review; pediatric palliative care; pediatric end-of-life; pediatric hospice; rural health care; rural hospice
Creator
An entity primarily responsible for making the resource
Stone W; Keim-Malpass J; Cozad MJ; Fornehed MLC; Lindley LC
Description
An account of the resource
BACKGROUND: Families increasingly desire to bring their children home from the acute care setting at end of life. This transition includes home to rural or remote areas. Little is known about the end-of-life care for children who reside in rural areas. OBJECTIVE: The purpose of this study was to comprehensively review and summarize the evidence regarding end-of-life care for children living in rural areas, identify key findings and gaps in the literature, and make recommendations for future research. METHODS: A systematic review was conducted from 2011 to 2021 using MEDLINE and CINAHL databases. RESULTS: Nine studies met inclusion criteria. Key themes from the literature included: barriers, facilitators, and needs. Three articles identified barriers to end-of-life care for children in rural communities, which included access to end-of-life care and clinicians trained to provide pediatric care. Three studies identified and evaluated the facilitators of end-of-life care for rural children. The articles identified technology and additional training as facilitators. Four studies reported on the needs of rural children for end-of-life care with serious illness. CONCLUSIONS: We found major barriers and unmet needs in the delivery of rural pediatric end-of-life care. A few facilitators in delivery of this type of care were explored. Overall research in this area was sparse. Future studies should focus on understanding the complexities associated with delivery of pediatric end-of-life care in rural areas.
Identifier
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<a href="http://doi.org/10.1177/10499091211064202" target="_blank" rel="noreferrer noopener">10.1177/10499091211064202</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2021
American Journal of Hospice and Palliative Medicine
Cozad MJ
February 2022 List
Fornehed MLC
Keim-Malpass J
Lindley LC
pediatric end-of-life
pediatric hospice
Pediatric Palliative Care
rural health care
rural hospice
Stone W
Systematic Review
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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January 2022 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
January 2022 List
URL Address
<a href="http://doi.org/10.1097/njh.0000000000000810" target="_blank" rel="noreferrer noopener">http://doi.org/10.1097/njh.0000000000000810</a>
Dublin Core
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A National Study to Compare Effective Management of Constipation in Children Receiving Concurrent Versus Standard Hospice Care
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Journal of Hospice & Palliative Nursing
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2021
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Medicaid; constipation; pediatric hospice care; concurrent hospice care; pediatric end of life
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Lindley LC; Keim-Malpass J; Cozad MJ; Mack JW; Svynarenko R; Fornehed MLC; Stone W; Qualls K; Hinds PS
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Constipation is a distressing and uncomfortable symptom children experience at end of life. There is a gap in knowledge about how different approaches to hospice care delivery might improve pediatric symptom management of constipation. The purpose of this study was to evaluate the effectiveness of pediatric concurrent hospice versus standard hospice care to manage constipation. Medicaid data (2011-2013) were analyzed. Children who were younger than 21 years enrolled in hospice care and had a hospice enrollment between January 1, 2011, and December 31, 2013, were included. Instrumental variable analysis was used to test the effectiveness of concurrent versus standard hospice care. Among the 18 152 children, approximately 14% of participants were diagnosed or treated for constipation from a nonhospice provider during hospice enrollment. A higher proportion of children received nonhospice care for constipation in concurrent hospice care, compared with standard hospice (19.5% vs 13.2%), although this was not significant (β = .22, P < .05) after adjusting for covariates. The findings demonstrated that concurrent care was no more effective than standard hospice care in managing pediatric constipation. Hospice and nonhospice providers may be doing a sufficient job ordering bowel regimens before constipation becomes a serious problem for children at end of life.
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<a href="http://doi.org/10.1097/njh.0000000000000810" target="_blank" rel="noreferrer noopener">10.1097/njh.0000000000000810</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2021
concurrent hospice care
Constipation
Cozad MJ
Fornehed MLC
Hinds PS
January 2022 List
Journal Of Hospice & Palliative Nursing
Keim-Malpass J
Lindley LC
Mack JW
Medicaid
pediatric end of life
Pediatric Hospice Care
Qualls K
Stone W
Svynarenko R
-
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January 2022 List
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<a href="http://doi.org/10.1111/jspn.12333" target="_blank" rel="noreferrer noopener">http://doi.org/10.1111/jspn.12333</a>
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Title
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Medical complexity and concurrent hospice care: A national study of Medicaid children from 2011 to 2013
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Journal for Specialists in Pediatric Nursing
Date
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2021
Subject
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pediatric; Child; United States; Hospices; Medicaid; Hospitalization; Patient Protection and Affordable Care Act; hospice care; end-of-life care; concurrent hospice care
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Keim-Malpass J; Cozad MJ; Svynarenko R; Mack JW; Lindley LC
Description
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PURPOSE: Pediatric hospice is a comprehensive model of care for medically complex children at end of life. The Affordable Care Act changed regulatory requirements for pediatric Medicaid enrollees to allow for enrollment into hospice services while still receiving life-prolonging therapy. There are gaps in understanding factors associated with pediatric concurrent hospice care use. The objectives were to examine the prevalence of concurrent hospice care overtime and investigated the relationship between medical complexity and concurrent hospice care among Medicaid children. DESIGN AND METHODS: We used national Medicaid data and included children less than 21 years with an admission to hospice care. Medical complexity was defined with four criteria (i.e., chronic conditions, functional limitations, high health care use and substantial needs). Using multivariate logistic regression, we evaluated the influence of medical complexity on concurrent hospice care use, while controlling for demographic, hospice, and community characteristics. RESULTS: Thirty-four percent of the study sample used concurrent hospice care. Medical complexity was unrelated to concurrent hospice care. However, the four individual criteria were associated. A complex chronic condition was negatively related to concurrent hospice care, whereas technology dependence, multiple complex chronic conditions, and mental/behavioral disorders were positively associated to concurrent care use. PRACTICE IMPLICATIONS: These findings suggest that concurrent hospice care may be important for a subset of medically complex children with functional limitations, high health utilization, and substantial needs at end of life.
Identifier
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<a href="http://doi.org/10.1111/jspn.12333" target="_blank" rel="noreferrer noopener">10.1111/jspn.12333</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2021
Child
concurrent hospice care
Cozad MJ
End-of-life Care
Hospice Care
Hospices
Hospitalization
January 2022 List
Journal for Specialists in Pediatric Nursing
Keim-Malpass J
Lindley LC
Mack JW
Medicaid
Patient Protection and Affordable Care Act
Pediatric
Svynarenko R
United States
-
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<a href="http://doi.org/10.1177/10499091211056039" target="_blank" rel="noreferrer noopener">http://doi.org/10.1177/10499091211056039</a>
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Title
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Effectiveness of Pediatric Concurrent Hospice Care to Improve Continuity of Care
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American Journal of Hospice and Palliative Medicine
Date
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2021
Subject
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pediatric hospice care; hospice length of stay; medicaid; concurrent hospice care; care continuity; emergency department use; hospice live discharge; inpatient admission
Creator
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Lindley LC; Cozad MJ; Mack JW; Keim-Malpass J; Svynarenko R; Hinds PS
Description
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BackgroundThe 2010 Patient Protection and Affordable Care Act (ACA) mandated landmark hospice care legislation for children at end of life. Little is known about the impact of pediatric concurrent hospice care.ObjectiveThe purpose of this study was to examine the effect of pediatric concurrent vs standard hospice care on end-of-life care continuity among Medicaid beneficiaries.MethodsUsing national Medicaid data, we conducted a quasi-experimental designed study to estimate the effect of concurrent vs standard hospice care to improve end-of-life care continuity for children. Care continuity (i.e., hospice length of stay, hospice disenrollment, emergency room transition, and inpatient transition) was measured via claims data. Exposures were concurrent hospice vs standard hospice care. Using instrumental variable analysis, the effectiveness of exposures on care continuity was compared.ResultsConcurrent hospice care affected care continuity. It resulted in longer lengths of stays in hospice (? = 2.76, P < .001) and reduced hospice live discharges (? = ?2.80, P < .05), compared to standard hospice care. Concurrent care was not effective at reducing emergency room (? = 2.09, P < .001) or inpatient care (? = .007, P < .05) transitions during hospice enrollment.ConclusionOur study provides critical insight into the quality of care delivered for children at end of life. These findings have policy implications.
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<a href="http://doi.org/10.1177/10499091211056039" target="_blank" rel="noreferrer noopener">10.1177/10499091211056039</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2021
American Journal of Hospice and Palliative Medicine
care continuity
concurrent hospice care
Cozad MJ
emergency department use
Hinds PS
Hospice Length Of Stay
hospice live discharge
inpatient admission
January 2022 List
Keim-Malpass J
Lindley LC
Mack JW
Medicaid
Pediatric Hospice Care
Svynarenko R
-
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Title
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October 2021 List
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October 2021 List
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<a href="http://doi.org/10.1891/JNM-D-19-00106" target="_blank" rel="noreferrer noopener">http://doi.org/10.1891/JNM-D-19-00106</a>
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Predictive Ability of an Illness Severity Measure: Implications for Nursing Research
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Journal of Nursing Measurement
Date
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2021
Subject
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pediatric; end-of-life; complex chronic conditions; infant; illness severity; measurement testing
Creator
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Lindley LC; Fortney CA; Cozad MJ
Description
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BACKGROUND AND PURPOSE: Illness severity among children with life-limiting illnesses is measured with the pediatric complex chronic conditions (CCC) measure. Developed in 2000/2001, it was revised in 2014 to include infant-specific categories. METHODS: Discrimination, calibration, accuracy, and validation tests were used to examine the predictive performance of the measures. RESULTS: Among the 10,175 infants in the analysis, both measures poorly discriminated-palliative care consultation (C-statistics 0.6396 vs. C-statistics 0.5905) and any inpatient procedure (C-statistics 0.6101 vs. C-statistics 0.5160). The Hosmer-Lemeshow goodness-of-fit tests revealed good calibration for both measures. The original measure was more accurate in predicting end-of-life outcomes-palliative care consultation (Brier Score 0.3892 vs. 0.7787) and any inpatient procedures (Brier Score 0.3115 vs. 0.4738). CONCLUSIONS: The revised measure did not perform any better than the original in predicting end-of-life outcomes among infants.
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<a href="http://doi.org/10.1891/JNM-D-19-00106" target="_blank" rel="noreferrer noopener">10.1891/JNM-D-19-00106</a>
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2021
Complex Chronic Conditions
Cozad MJ
end-of-life
Fortney CA
illness severity
Infant
Journal of Nursing Measurement
Lindley LC
measurement testing
October 2021 List
Pediatric
-
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Title
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December 2020 List
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December 2020 List
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<a href="http://doi.org/10.1177/0193945919867266" target="_blank" rel="noreferrer noopener">http://doi.org/10.1177/0193945919867266</a>
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Title
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Pediatric Complex Chronic Conditions: Evaluating Two Versions of the Classification System
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Western journal of nursing research
Date
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2020
Subject
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complex chronic conditions; hcup kid; infants; positive predictive value; sensitivity; specificity
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Lindley LC; Cozad MJ; Fortney CA
Description
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The original pediatric complex chronic conditions (CCC) classification system developed in 2000/2001 is the gold standard in classifying children with life-limiting illnesses. It was significantly modified in 2014; yet the two systems have not been evaluated. The objective of this study was to evaluate the agreement and validity of the original versus the modified CCC classification systems. Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Database (KID) data from 2012 was used with a sample of infant decedents less than 1 years. The agreement (i.e., Cohen's Kappa Statistic) and validity (i.e., sensitivity, specificity, and positive predictive value [PPV]) statistics were calculated. Among the 10,175 infants that were classified, the modified system performed well in identifying infants who had a CCC, and it captured infants that the original classification did not. The modified system represents an improvement over the original, but additional testing is warranted.
Identifier
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<a href="http://doi.org/10.1177/0193945919867266" target="_blank" rel="noreferrer noopener">10.1177/0193945919867266</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2020
Complex Chronic Conditions
Cozad MJ
December 2020 List
Fortney CA
hcup kid
Infants
Lindley LC
positive predictive value
sensitivity
specificity
Western Journal of Nursing Research
-
Text
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Citation List Month
October 2017 List
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Title
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Comparative Effectiveness of Usual Source of Care Approaches to Improve End-of-life Outcomes for Children with Intellectual Disability
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Journal Of Pain and Symptom Management
Date
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2017
Subject
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Case Management; Comparative Effectiveness; Emergency Room Utilization; Hospital Readmissions; Intellectual Disability; Pediatric Hospice Care; Usual Source Of Care
Creator
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Lindley LC; Cozad MJ
Description
An account of the resource
CONTEXT: Children with intellectual disability (ID) are at risk for adverse end-of-life outcomes including high emergency room utilization and hospital readmissions, along with low hospice enrollment. OBJECTIVES: The objective of this study was to compare the effectiveness of usual source of care approaches to improve end-of-life outcomes for children with ID. METHODS: We used longitudinal California Medicaid claims data. We included children who were less than 21 years with fee-for-service Medicaid claims, died between January 1, 2007 and December 31, 2010, and had a moderate to profound ID diagnosis. End-of-life outcomes (i.e., hospice enrollment, emergency room utilization, hospital readmissions) were measured via claims data. Our treatments were usual source of care (USC) only versus usual source of care plus targeted case management (USC plus TCM). Using instrumental variable analysis, we compared the effectiveness of treatments on end-of-life outcomes. RESULTS: Ten percent of children with ID enrolled in hospice, 73% utilized the emergency room, and 20% had 3 or more hospital admissions in their last year of life. USC plus TCM relative to USC only had no effect on hospice enrollment; however, it significantly reduced the probability of emergency room utilization (B=-1.29, p<0.05) and hospital readmissions (B=-1.71, p<0.001). CONCLUSIONS: Our findings demonstrated that USC plus TCM was more effective at improving end-of-life outcomes for children with ID. Further study of the extent of UCS and TCM involvement in reducing emergency room utilization and hospital readmissions at end of life is needed.
Identifier
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10.1016/j.jpainsymman.2017.06.007
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2017
Case Management
Comparative Effectiveness
Cozad MJ
Emergency Room Utilization
Hospital Readmissions
Intellectual Disability
Journal Of Pain & Symptom Management
Lindley LC
October 2017 List
Pediatric Hospice Care
Usual Source Of Care
-
Text
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Citation List Month
November 2016 List
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Title
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Staff Efficiency Trends Among Pediatric Hospices, 2002-2011.
Publisher
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Nursing Economic$
Date
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2016
Subject
The topic of the resource
Adolescent; California; Child; Child Preschool; Efficiency Organizational/statistics & Numerical Data; Female; Forecasting; Hospice Care/statistics & Numerical Data; Hospice Care/trends; Hospice Care/statistics & Numerical Data; Hospices/trends; Hospitals Pediatric/statistics & Numerical Data; Hospitals Pediatric; Humans; Infant; Infant Newborn; Male; Personnel Staffing And Scheduling/statistics & Numerical Data; Personnel Staffing And Scheduling/trends; Workload/statistics & Numerical Data; Young Adult
Creator
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Cozad MJ; Lindley LC; Mixer SJ
Description
An account of the resource
This study provided the first examination of staff efficiency trends among pediatric hospices. Although pediatric staff efficiency demonstrated large variability from 2002 to 2011, the general trend in efficiency from 2003 to 2010. The decline in efficiency means, on average, pediatric hospices had higher operating expenses and used more capacity, but greater amounts of these greater outputs as measured by visits per patient. The study also highlights the crucial role pediatric hospice nurse managers play in developing effective workforce strategies that allow for responsive changes to workload fluctuations. Due to the associations between efficiency, regulation, and growth, nurse leaders' abilities to develop effective strategies are more imperative than ever to ensure quality end-of-life care for children and their families.
Identifier
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PMCID: PMC5045247
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2016
Adolescent
California
Child
Child Preschool
Cozad MJ
Efficiency Organizational/statistics & Numerical Data
Female
Forecasting
Hospice Care/statistics & Numerical Data
Hospice Care/trends
Hospices/trends
Hospitals Pediatric
Hospitals Pediatric/statistics & Numerical Data
Humans
Infant
Infant Newborn
Lindley LC
Male
Mixer SJ
November 2016 List
Nursing Economic$
Personnel Staffing And Scheduling/statistics & Numerical Data
Personnel Staffing And Scheduling/trends
Workload/statistics & Numerical Data
Young Adult
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
May 2016 List
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Nurse Knowledge, Work Environment, And Turnover In Highly Specialized Pediatric End-of- Life Care.
Publisher
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American Journal Of Hospice And Palliative Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2016
Subject
The topic of the resource
Rn Turnover; Rn Work Environment; Advanced Practice Nurses; Nurse Intellectual Capital Theory; Perinatal Hospice; Perinatal Palliative Care
Creator
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Lindley LC; Cozad MJ
Description
An account of the resource
OBJECTIVE:
To examine the relationship between nurse knowledge, work environment, and registered nurse (RN) turnover in perinatal hospice and palliative care organizations.
METHODS:
Using nurse intellectual capital theory, a multivariate analysis was conducted with 2007 National Home and Hospice Care Survey data.
RESULTS:
Perinatal hospice and palliative care organizations experienced a 5% turnover rate. The professional experience of advanced practice nurses (APNs) was significantly related to turnover among RNs (β = -.032, P < .05). Compared to organizations with no APNs professional experience, clinical nurse specialists and nurse practitioners significantly reduced RN turnover by 3 percentage points. No other nurse knowledge or work environment variables were associated with RN turnover. Several of the control variables were also associated with RN turnover in the study; Organizations serving micropolitan (β = -.041, P < .05) and rural areas (β = -.037, P < .05) had lower RN turnover compared to urban areas. Organizations with a technology climate where nurses used electronic medical records had a higher turnover rate than those without (β = .036, P < .05).
CONCLUSION:
The findings revealed that advanced professional experience in the form of APNs was associated with reductions in RN turnover. This suggests that having a clinical nurse specialist or nurse practitioner on staff may provide knowledge and experience to other RNs, creating stability within the organization.
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2016
Advanced Practice Nurses
American Journal of Hospice and Palliative Medicine
Cozad MJ
Lindley LC
May 2016 List
Nurse Intellectual Capital Theory
Perinatal Hospice
Perinatal Palliative Care
Rn Turnover
Rn Work Environment