- 作者：Lisa C. Lindley ; PhD ; RN<sup> ; sup><sup>llindley@utk.edu" class="auth_mail" title="E-mail the corresponding authorsup>
- 关键词：Pediatric hospice utilization ; pediatric palliative care policy ; Medicaid ; Andersen behavioral model
- 刊名：Journal of Pain and Symptom Management
- 出版年：2016
- 出版时间：November 2016
- 年：2016
- 卷：52
- 期：5
- 页码：688-694
- 全文大小：148 K
sSec_2">Objectives
spara0015">The aim of this study was to examine the effect of the palliative care policy on hospice utilization for children and their families was investigated.
sSec_3">Methods
spara0020">Using 2007 and 2010 California Medicaid data, a difference-in-difference analysis was conducted to analyze hospice use (i.e., hospice enrollment, hospice length of stay) changes for children who resided in pediatric policy counties relative to those who did not. The sample of children in California who died with a life-threatening serious illness in 2007 and 2010 equaled 979 children.
sSec_4">Results
spara0030">More than 10% of children enrolled in hospice care with an average of less than 3 days of hospice care. The palliative care policy did not have any effect on hospice enrollment. However, the policy was positively associated with increasing days in hospice care (incidence rate ratio = 5.61, P < 0.05). The rate of hospice length of stay increased by a factor of 5.61 for children in palliative care counties compared with children unaffected by the policy.
sSec_5">Conclusion
spara0035">The pediatric palliative care policy was associated with longer lengths of stay in hospice once the children were enrolled. Policies promoting palliative care are critical to ensuring access to hospice care for children.