Medical complexity and concurrent hospice care: A national study of Medicaid children from 2011 to 2013

Title

Medical complexity and concurrent hospice care: A national study of Medicaid children from 2011 to 2013

Creator

Keim-Malpass J; Cozad MJ; Svynarenko R; Mack JW; Lindley LC

Identifier

Publisher

Journal for Specialists in Pediatric Nursing

Date

2021

Subject

pediatric; Child; United States; Hospices; Medicaid; Hospitalization; Patient Protection and Affordable Care Act; hospice care; end-of-life care; concurrent hospice care

Description

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.

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

January 2022 List

Collection

Citation

Keim-Malpass J; Cozad MJ; Svynarenko R; Mack JW; Lindley LC, “Medical complexity and concurrent hospice care: A national study of Medicaid children from 2011 to 2013,” Pediatric Palliative Care Library, accessed May 23, 2022, https://pedpalascnetlibrary.omeka.net/items/show/17774.

Social Bookmarking