Pediatric Palliative Care Program versus Usual Care and Healthcare Resource Utilization in British Columbia: A Matched-Pairs Cohort Study

Abstract

The terminal pediatric population referred to PPCP may systematically differ from those under usual care even before enrollment, presenting with higher inpatient utilization in critical care nearing death. A significant portion of inpatient utilization shifted to the hospice, with implications for resource reallocation and enhancements in PPCP referrals.

Instruments to Measure Outcomes in Pediatric Palliative Care: A Systematic Review

“…QoL, when explicitly explored, was defined as "having fun or experiencing events that added meaning to life." 23,26,27 Other outcomes were related to satisfaction with care and communication with health care professionals, often in parallel with the opportunity given to the children or adolescents to express their wishes, treatment preferences, or place of care. Finally, the length of hospitalization or the place of death were outcomes searched for through chart review and interpreted by authors as quality indicators of services.…”

Repercussões dos cuidados paliativos pediátricos: revisão integrativa

“…There may be subtle changes in the use of resources, such as the reduction in surgical approaches observed by Ananth and collaborators 14 . However, for terminally ill patients, palliative care may not substantially change hospital use -a finding also reported by Smith and collaborators 13 and Conte and collaborators 15 . Although the exact mechanisms of decreased hospital use require further investigation, PPC facilitates the reallocation of hospital care to the outpatient level, with early conversations about care planning, including care staff, patient and family members.…”

“…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.…”

“…All studies were produced outside Brazil. Six of them were published in Journal of Palliative Medicine 10,14,15,17,20,21 , two in Pediatric Clinics of North America 18,19 , two in BMC Palliative Care 11,23 and the others in Palliative Medicine 12 , Annali dell'Istituto Superiore di Sanità 22 , Journal of Pain and Symptom Management 16 and Pediatrics 13 .…”

“…The qualitative design was observed in two studies, with interviews 12 or questionnaires 10 . Another nine studies 11,[13][14][15][16]18,19,21,22 had a quantitative approach, with a predominance of cohort studies. One study 17 had a qualitative (by interview) and quantitative (by cost analysis) approach, and another was of descriptive nature 20 .…”