Clusters Of Multiple Complex Chronic Conditions: A Latent Class Analysis Of Children At End Of Life.
Title
Clusters Of Multiple Complex Chronic Conditions: A Latent Class Analysis Of Children At End Of Life.
Creator
Lindley LC; Mack JW; Bruce DJ
Publisher
Journal Of Pain And Symptom Management
Date
2016
Subject
Hospice Care; Pediatrics; Complex Chronic Conditions; Medicare Managed Care; Child; Clinical Neurology; Cancer; Palliative Care; Dependence; Latent Class Analysis; Couples; End Of Life Care; Health Care Sciences & Services Medicine General & Internal
Complex Chronic Conditions; Children; End Of Life; Latent Class Analysis; Pediatrics
Description
CONTEXT:
Children at end of life often experience multiple complex chronic conditions with more than 50% of children reportedly having two or more conditions. These complex chronic conditions are unlikely to occur in an entirely uniform manner in children at end of life. Previous work has not fully accounted for patterns of multiple conditions when evaluating care among these children.
OBJECTIVES:
The objective of the study was to understand the clusters of complex chronic conditions present among children in the last year of life.
METHODS:
Participants were 1423 pediatric decedents from the 2007 to 2008 California Medicaid data. A latent class analysis was used to identify clusters of children with multiple complex chronic conditions (neurological, cardiovascular, respiratory, renal, gastrointestinal, hematologic, metabolic, congenital, cancer). Multinomial logistic regression analysis was used to examine the relationship between demographic characteristics and class membership.
RESULTS:
Four latent classes were yielded: medically fragile (31%); neurological (32%); cancer (25%); and cardiovascular (12%). Three classes were characterized by a 100% likelihood of having a complex chronic condition coupled with a low or moderate likelihood of having the other eight conditions. The four classes exhibited unique demographic profiles.
CONCLUSION:
This analysis presented a novel way of understanding patterns of multiple complex chronic conditions among children that may inform tailored and targeted end-of-life care for different clusters.
Children at end of life often experience multiple complex chronic conditions with more than 50% of children reportedly having two or more conditions. These complex chronic conditions are unlikely to occur in an entirely uniform manner in children at end of life. Previous work has not fully accounted for patterns of multiple conditions when evaluating care among these children.
OBJECTIVES:
The objective of the study was to understand the clusters of complex chronic conditions present among children in the last year of life.
METHODS:
Participants were 1423 pediatric decedents from the 2007 to 2008 California Medicaid data. A latent class analysis was used to identify clusters of children with multiple complex chronic conditions (neurological, cardiovascular, respiratory, renal, gastrointestinal, hematologic, metabolic, congenital, cancer). Multinomial logistic regression analysis was used to examine the relationship between demographic characteristics and class membership.
RESULTS:
Four latent classes were yielded: medically fragile (31%); neurological (32%); cancer (25%); and cardiovascular (12%). Three classes were characterized by a 100% likelihood of having a complex chronic condition coupled with a low or moderate likelihood of having the other eight conditions. The four classes exhibited unique demographic profiles.
CONCLUSION:
This analysis presented a novel way of understanding patterns of multiple complex chronic conditions among children that may inform tailored and targeted end-of-life care for different clusters.
Rights
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).
Citation List Month
May 2016 List
Citation
Lindley LC; Mack JW; Bruce DJ, “Clusters Of Multiple Complex Chronic Conditions: A Latent Class Analysis Of Children At End Of Life.,” Pediatric Palliative Care Library, accessed April 23, 2024, https://pedpalascnetlibrary.omeka.net/items/show/10594.