An economic examination of private insurance claims among adolescents and young adults who were enrolled in hospice during the last year of life

Abstract

PurposeThe purpose of this study was to generate baseline data on the health characteristics, health care utilization, and health care spending among privately insured adolescents and young adults (AYA), who were enrolled in hospice care during their last year of life.MethodsA retrospective, nonexperimental design was used to collect and analyze longitudinal claims data from the Truven Health MarketScan™ database. The sample included AYA (aged 15–24 years) who utilized hospice during their last year of life.ResultsTotally, 17,408 AYA were included in this analysis. Mean hospice length of stay (LOS) was low overall, but there was a statistically significant difference in hospice LOS in ages 15–19 years (mean 3.56, SD 15.17 days) compared with those aged 20–24 years (mean 2.26, SD 8.24; P<0.001 days). More than a third (37%) of the AYAs used the emergency department during the last year of life and 83% sought care from a primary care visit. However, only 6% of the sample who were hospice enrollees used frequent inpatient hospital services.ConclusionsThis study provides preliminary data for private insurance expenditures and clinical utilization for AYA who were enrolled in hospice. This analysis also provides initial evidence to suggest extremely short hospice LOS for AYAs prior to the end of life and represents an area of future research need.

Nursing science as a federally-recognized STEM degree: A call to action for the United States with global implications

“…Further, cost evaluations of nursing care delivery communicate value through metrics that are translatable to administrators and policymakers ( Aiken, 2008 ). Beyond issues pertaining to the profession as a whole, health economics has been a critical methodological application applied by nurse scientists in the assessment of novel interventions or models of care ( Cozad et al., 2016 ; Iribarren et al., 2017 ; Keim-Malpass et al., 2018 ). Numerous economic departments have changed their formal classification of programs to the STEM classification inclusive of econometrics and quantitative economics so international graduate students can access the benefits of the STEM-designated academic programs for their application of H1-B visa ( Redden, 2016 ).…”

Pediatric End-of-Life Care in Rural America: A Systematic Review

“…We know that children and their families encounter a range issues related to the difficulty of prognosis of their pediatric serious illnesses, insufficient policy and resources, lack of health professionals with training in pediatric end-of-life care, lack of pediatric advance directives, and cultural/social beliefs related to pediatric death and dying. [9][10][11][12][13] We also know that many of these challenges are intensified when children reside in rural areas. For example, in areas of rural Appalachia many families hold the belief that hospice care hastens death.…”