Community-based pediatric palliative care for health related quality of life, hospital utilization and costs lessons learned from a pilot study

Abstract

BackgroundChildren with chronic complex-medical conditions comprise a small minority of children who require substantial healthcare with major implications for hospital utilization and costs in pediatrics. Community-Based Pediatric Palliative Care (CBPPC) provides a holistic approach to patient care that can improve their quality of life and lead to reduced costs of hospital care. This study's purpose was to analyze and report unpublished evaluation study results from 2007 that demonstrate the potential for CBPPC on Health Related Quality of Life (HRQoL) and hospital utilization and costs in light of the increasing national focus on the care of children with complex-medical conditions, including the Affordable Care Act's emphasis on patient-centered outcomes.MethodsA multi-method research design used primary data collected from caregivers to determine the Program's potential impact on HRQoL, and administrative data to assess the Program's potential impact on hospital utilization and costs. Caregivers (n=53) of children enrolled in the Northeast Florida CBPPC program (Community PedsCare) through the years 2002-2007 were recruited for the Health Related Quality of Life (HRQoL) study. Children (n=48) enrolled in the Program through years 2000-2006 were included in the utilization and cost study.ResultsHRQoL was generally high, and hospital charges per child declined by $1203 for total hospital services (p=.34) and $1047 for diagnostic charges per quarter (p=0.13). Hospital length of stay decreased from 2.92 days per quarter to 1.22 days per quarter (p<.05).ConclusionThe decrease in hospital utilization and costs and the high HRQoL results indicate that CBPPC has the potential to influence important outcomes for the quality of care available for children with complex-medical conditions and their caregivers.Electronic supplementary materialThe online version of this article (doi:10.1186/s12904-016-0138-z) contains supplementary material, which is available to authorized users.

Measuring the Impact of the Home Health Nursing Shortage on Family Caregivers of Children Receiving Palliative Care

“… 4 Many children with complex medical conditions remain in the hospital away from their families, although home health care is clearly cost effective as compared with inpatient medical management. 28 , 29 …”

Building Bridges, Paediatric Palliative Care in Belgium: A secondary data analysis of annual paediatric liaison team reports from 2010 to 2014

“…This coordination between specialists and primary health services can be found in community-based PPC such as reported by Kaye et al [ 16 ]. According to Goldhagen et al this model was even found to improve health-related quality of life and to reduce hospitalisation utilisation and costs [ 38 ].…”

Repercussões dos cuidados paliativos pediátricos: revisão integrativa

“…Four articles included in the sample were published in 2014 10,18,19,21 , two in 2015 13,17 , five in 2016 15,16,20,22,23 , two in 2017 12,14 and one in 2018 11 . All studies were produced outside Brazil.…”