No abstract

P ediatric palliative care can be summarized as "an active and total approach to care focused on the enhancement of quality of life for the children with life-threatening conditions and support for the family".1 A life-threatening condition is a condition with no established cure, or for which available treatment has not succeeded, and survival to full adulthood is unlikely. Children requiring, but not enrolled in, a pediatric palliative care program (PPCP) access usual care often through uncoordinated acute care admissions and some episodes of home care, but potentially with some compromise to continuity of care where critical components for family support are lacking. Complex care plans and fluctuating patient needs necessitate a coordination of care within individualized support systems.Pediatric palliative care is a relatively new and evolving field. It varies from adult palliative care in important ways. From a resource utilization perspective, pediatric palliative care is usually delivered over a longer time frame. 2,3It is unclear how enrolment in a PPCP affects health care utilization and costs compared with usual care. Understanding such outcomes may improve the efficiency of health care services for children with life-threatening conditions and support evidence-based planning and resource allocation for PPCPs. We conducted a systematic review of the published literature where inpatient health care resource utilization and costs were compared between children with life-threatening conditions who accessed a PPCP and those who did not. Background: Pediatric palliative care is a relatively new and evolving field, and the cost of pediatric palliative care programs is unclear. We conducted a systematic review to compare inpatient health care utilization and costs among children with life-threatening conditions who have accessed a pediatric palliative care program and those who have not.

Many COPD models have been developed, generally with similar structural elements. COPD is highly heterogeneous, and comorbid conditions play an important role in its burden. These important aspects, however, have not been adequately addressed in most of the published models.