Pediatric Primary Care Involvement In End-of-life Care For Children

Title

Pediatric Primary Care Involvement In End-of-life Care For Children

Creator

Lindley LC; Nageswaran S

Identifier

10.1177/1049909115609589

Publisher

American Journal Of Hospice And Palliative Medicine

Date

2017

Subject

Primary Health Care/sn [statistics & Numerical Data]; Terminal Care/sn [statistics & Numerical Data]; Adolescent; Age Factors; California; Child; Child Preschool; Female; Home Care Services/sn [statistics & Numerical Data]; Hospice Care/sn [statistics & Numerical Data]; Humans; Infant; Male; Retrospective Studies; Young Adult

Description

OBJECTIVES: To examine the relationship between pediatric primary care involvement and hospice and home health care use at end of life. METHODS: California Medicaid data were used to estimate the relationship between pediatric primary care involvement and use of hospice and home health care using generalized estimating equations. RESULTS: Of the 2037 children who died between 2007 and 2010, 11% used hospice and 23% used home health. Among all children, primary care was not related to hospice use and was associated with home health use, usual source of care (OR = 1.83, P < .05), comprehensive care (OR = 1.60, P < .05), and continuous care (low: OR = 1.49, P < .05; moderate: OR = 2.57, P < .05; high: OR = 2.12, P < .05). Primary care for children aged 15 to 20 years was related to hospice use, usual source of care (OR = 4.06, P < .05) and continuous care (low: OR = 4.92, P < .05; moderate OR = 4.09, P < .05; high OR = 3.92, P < .05). Primary care for children under 5 years was associated with home health use, usual source of care (OR = 2.59, P < .05), comprehensive care (OR = 2.49, P < .05), and continuous care (low: OR = 2.22, P < .05; moderate: OR = 3.64, P < .05; high: OR = 3.62, P < .05). For children aged 6 to 14 years, this association was seen with continuous care (moderate: OR = 2.38, P < .05; high: OR = 2.13, P < .05). Home health for children aged 15 to 20 years was related to continuous care (moderate: OR = 2.32, P < .05). CONCLUSION: Primary care involvement affected hospice use among older age-groups and home health use among younger age-groups. These findings underscore the need for clinical knowledge about end-of-life care for children of all ages among primary care providers.

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

September 2017 List

Notes

Lindley, Lisa C Nageswaran, Savithri 1049909115609589

Citation

Lindley LC; Nageswaran S, “Pediatric Primary Care Involvement In End-of-life Care For Children,” Pediatric Palliative Care Library, accessed August 3, 2021, https://pedpalascnetlibrary.omeka.net/items/show/10780.

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