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Pediatric hospice

Lisa C Lindley, Sheri L Edwards
OBJECTIVE: To map and describe the geographic distribution of pediatric hospice care need versus supply in California over a 4-year time period (2007-2010). METHODS: Multiple databases were used for this descriptive longitudinal study. The sample consisted of 2036 children and adolescent decedents and 136 pediatric hospice providers. Geocoded data were used to create the primary variables of interest for this study-need and supply of pediatric hospice care. Geographic information systems were used to create heat maps for analysis...
November 11, 2016: American Journal of Hospice & Palliative Care
Corina Noje, Meghan L Bernier, Philomena M Costabile, Bruce L Klein, Sapna R Kudchadkar
OBJECTIVES: To present our single-center's experience with three palliative critical care transports home from the PICU for terminal extubation. DESIGN: We performed a retrospective chart review of patients transported between January 1, 2012, and December 31, 2014. SETTING: All cases were identified from our institutional pediatric transport database. PATIENTS: Patients were terminally ill children unable to separate from mechanical ventilation in the PICU, who were transported home for terminal extubation and end-of-life care according to their families' wishes...
October 28, 2016: Pediatric Critical Care Medicine
Lisa C Lindley
BACKGROUND: Over 42,000 children die each year in the United States, including many with multiple complex chronic conditions (MCCCs), but little is known about whether the presence of MCCCs influences families to utilize pediatric hospice care. OBJECTIVE: The study objective was to examine the relationship between MCCCs and pediatric hospice utilization among Medicaid beneficiaries. METHODS: A retrospective, longitudinal cohort design was conducted with 2007-2010 California Medicaid data to examine the relationship between MCCCs (i...
October 31, 2016: Journal of Palliative Medicine
Lisa C Lindley
CONTEXT: California implemented pediatric palliative care legislations that allowed children to receive curative and supportive care from diagnosis of a life-threatening serious illness in 2010. Palliative care policies may improve access to hospice care as children near end of life. OBJECTIVES: 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. METHODS: Using 2007 and 2010 California Medicaid data, a difference-in-difference analysis was conducted to analyze hospice use (i...
November 2016: Journal of Pain and Symptom Management
Pascale Roger Dalbert, Marie-Charlotte d'Anjou
Compilio is a free and secure personal health record (PHR). It is an Internet based innovative tool for families and health professionals. Compilio aims to improve the coordination of the care course for people having specific needs related to a handicap or a chronic disease. Compilio is a project of the "Agence régionale de Santé Auvergne-Rhone-Alpes" and the NGO network R4P (Regional Network of Pediatric Re-education and Re-adaptation in Rhône-Alpes), developed with the participation of Civil hospices of Lyon and GCS SISRA...
September 2016: Annals of Physical and Rehabilitation Medicine
Lisa C Lindley, Laura V Trujillo
INTRODUCTION: More than 8,000 Hispanic children die annually in the United States; yet little is known about the end-of-life care utilized. The purpose of this study was to examine the children and family characteristics associated with end-of-life care for Hispanic children. METHOD: A sample of 370 Hispanic children was created, using the 2009-2010 California Medicaid data. The relationship between child and family characteristics and end-of-life care utilization (i...
December 2016: Hispanic Health Care International: the Official Journal of the National Association of Hispanic Nurses
Naveen Salins, Raghavendra Ramanjulu, Lipika Patra, Jayita Deodhar, Mary Ann Muckaden
INTRODUCTION: World Health Organization and American Society of Clinical Oncology recommend early integration of specialist palliative care in patients with cancer. This paper focuses on critical review of evidence on integration of early specialist palliative care in cancer care and patient-related outcomes. METHODS: The question for the literature search was - Does integration of early specialist palliative care in cancer care influences patient-related outcomes? 31 articles related to literature search review question were included in this paper...
July 2016: Indian Journal of Palliative Care
Tania Conte, Craig Mitton, Shannon Erdelyi, Negar Chavoshi, Harold Siden
BACKGROUND: Evidence on the impact of pediatric palliative care programs (PPCP) on resource utilization is scarce and requires broader measures to include utilization beyond the hospital setting. OBJECTIVE: This research aims to provide a Canadian comparative analysis between children in a PPCP with those under usual care, including hospice use to inpatient resource use measurement. METHODS: We conducted a retrospective matched-pairs (disease and age at death) cohort comparison of children who died in hospice versus hospital (never enrolled in a PPCP), from 2008 to 2012...
July 25, 2016: Journal of Palliative Medicine
Melanie J Cozad, Lisa C Lindley, Sandra J Mixer
This study provided the first examination of staff efficiency trends among pediatric hospices. Although pediatric staff efficiency demonstrated large variability from 2002 to 2011, the general trend in efficiency from 2003 to 2010. The decline in efficiency means, on average, pediatric hospices had higher operating expenses and used more capacity, but greater amounts of these greater outputs as measured by visits per patient. The study also highlights the crucial role pediatric hospice nurse managers play in developing effective workforce strategies that allow for responsive changes to workload fluctuations...
March 2016: Nursing Economic$
Lisa C Lindley, Katherine M Newnam
BACKGROUND: Infant deaths account for a majority of all pediatric deaths. However, little is known about the factors that influence parents to use hospice care for their infant with a life-threatening health condition. METHODS: Data were used from 2007 to 2010 California Medicaid claims files (n = 207). Analyses included logistic and negative binomial multivariate regression models. RESULTS: More than 15% of infants enrolled in hospice care for an average of 5 days...
May 28, 2016: Journal of Pediatric Health Care
Daphna Gans, Max W Hadler, Xiao Chen, Shang-Hua Wu, Robert Dimand, Jill M Abramson, Betty Ferrell, Allison L Diamant, Gerald F Kominski
CONTEXT: In 2010, California launched Partners for Children (PFC), a pediatric palliative care pilot program offering hospice-like services for children eligible for full-scope Medicaid delivered concurrently with curative care, regardless of the child's life expectancy. OBJECTIVES: We assessed the change from before PFC enrollment to the enrolled period in 1) health care costs per enrollee per month (PEPM), 2) costs by service type and diagnosis category, and 3) health care utilization (days of inpatient care and length of hospital stay)...
September 2016: Journal of Pain and Symptom Management
Lisa C Lindley, Melanie J Cozad
OBJECTIVE: To examine the relationship between nurse knowledge, work environment, and registered nurse (RN) turnover in perinatal hospice and palliative care organizations. METHODS: Using nurse intellectual capital theory, a multivariate analysis was conducted with 2007 National Home and Hospice Care Survey data. RESULTS: Perinatal hospice and palliative care organizations experienced a 5% turnover rate. The professional experience of advanced practice nurses (APNs) was significantly related to turnover among RNs (β = -...
May 17, 2016: American Journal of Hospice & Palliative Care
Arun L Singh, Jeffrey C Klick, Courtney E McCracken, Kiran B Hebbar
BACKGROUND: Hospice and Palliative Medicine (HPM) competencies are of growing importance in training general pediatricians and pediatric sub-specialists. The Accreditation Council for Graduate Medical Education (ACGME) emphasized pediatric trainees should understand the "impact of chronic disease, terminal conditions and death on patients and their families." Currently, very little is known regarding pediatric trainee education in HPM. METHODS: We surveyed all 486 ACGME-accredited pediatric training program directors (PDs) - 200 in general pediatrics (GP), 57 in cardiology (CARD), 64 in critical care medicine (CCM), 69 in hematology-oncology (ONC) and 96 in neonatology (NICU)...
April 26, 2016: American Journal of Hospice & Palliative Care
Yen-Ni Hung, Tsang-Wu Liu, Dong-Tsamn Lin, Yueh-Chih Chen, Jen-Shi Chen, Siew Tzuh Tang
Aggressive life-sustaining treatments have the potential to be continued beyond benefit, but have seldom been systematically/nationally explored in pediatric cancer patients. Furthermore, factors predisposing children dying of cancer to receive life-sustaining treatments at end of life (EOL) have never been investigated in a population-based study. This population-based study explored determinants of receiving life-sustaining treatments in pediatric cancer patients' last month of life. For this retrospective cohort study, we used administrative data on 1603 Taiwanese pediatric cancer patients who died in 2001 to 2010...
April 2016: Medicine (Baltimore)
Lisa C Lindley, Mary L Held, Kristen M Henley, Kathryn A Miller, Katherine E Pedziwol, Laurie E Rumley
BACKGROUND: Provision of language services in pediatric hospice enables nurses to communicate effectively with patients who have limited English proficiency. Language barriers contribute to ethnic disparities in health care. While language service use corresponds with improved patient comprehension of illness and care options, we lack an understanding of how the nurse work environment affects the provision of these services. METHODS: Data were obtained from the 2007 National Home and Hospice Care Survey and included a study sample of 1251 pediatric hospice agencies...
April 8, 2016: Journal of Racial and Ethnic Health Disparities
Jane Greene Ryan, Krista Haas, Natalene Kramer, Nora Vizzachero, Suzanne Butler, Elen Waechtler
No abstract text is available yet for this article.
May 2016: Journal of Pediatric Nursing
Christina K Ullrich, Leslie Lehmann, Wendy B London, Dongjing Guo, Madhumitha Sridharan, Richard Koch, Joanne Wolfe
Stem cell transplantation (SCT) is an intensive therapy offering the possibility of cure for life-threatening conditions but with risk of serious complications and death. Outcomes associated with pediatric palliative care (PPC) for children who undergo SCT are unknown. Therefore, we evaluated whether PPC consultation is associated with differences in end-of-life (EOL) care patterns for children who underwent SCT and did not survive. Medical records of children who underwent SCT at Boston Children's Hospital/Dana-Farber Cancer Institute for any indication from September 2004 to December 2012 and did not survive were reviewed...
June 2016: Biology of Blood and Marrow Transplantation
Katherine A Auger, Emily L Mueller, Steven H Weinberg, Catherine S Forster, Anita Shah, Christine Wolski, Grant Mussman, Anna J Ipsaro, Matthew M Davis
OBJECTIVE: To validate the accuracy of pre-encounter hospital designation as a novel way to identify unplanned pediatric readmissions and describe the most common diagnoses for unplanned readmissions among children. STUDY DESIGN: We examined all hospital discharges from 2 tertiary care children's hospitals excluding deaths, normal newborn discharges, transfers to other institutions, and discharges to hospice. We performed blinded medical record review on 641 randomly selected readmissions to validate the pre-encounter planned/unplanned hospital designation...
March 2016: Journal of Pediatrics
Lisa Humphrey, Tammy I Kang
Children with advanced cancer, including those with hematologic malignancies, can benefit from interdisciplinary palliative care services. Palliative care includes management of distressing symptoms, attention to psychosocial and spiritual needs, and assistance with navigating complex medical decisions with the ultimate goal of maximizing the quality-of-life of the child and family. Palliative care is distinct from hospice care and can assist with the care of patients throughout the cancer continuum, irrespective of prognosis...
2015: Hematology—the Education Program of the American Society of Hematology
Kelly Komatz, Brian Carter
Pain and symptom management is considered one of the cornerstones of palliative and hospice medicine. However, general clinicians and specialists are not usually comfortable addressing the most common forms of pain seen in the pediatric population. In addition, non-pain symptom management, especially when related to underlying chronic medical conditions, can be managed by the general clinician and specialists. The goal of this article is to educate clinicians about pain categories, taking a detailed pain history, and developing a plan for treatment, including nonpharmacologic methods...
December 2015: Pediatrics in Review
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