Comparative Effectiveness of Usual Source of Care Approaches to Improve End-of-Life Outcomes for Children With Intellectual Disability

Abstract

Our findings demonstrated that USC plus TCM was more effective at improving end-of-life outcomes for children with ID. Further study of the extent of UCS and TCM involvement in reducing emergency room utilization and hospital readmissions at end of life is needed.

Children Enrolled in Hospice Care Under Commercial Insurance: A Comparison of Different Age Groups

“…In studies among children who died while enrolled in Medicaid, the percentage of hospital readmissions ranged from 21% to 29% and ED utilization ranged from 52% to 72%. 11,12 Overall, these utilization findings suggest that pediatric patients at end of life are maintaining a relationship with their primary care physicians. Although the data did not allow for an investigation into case management for these children, it would be interesting to examine whether or not primary care physicians are actively managing intensive health care utilizations such as multiple hospital admissions and ED visits, as children prepare to enroll in hospice care.…”

“…Although the data did not allow for an investigation into case management for these children, it would be interesting to examine whether or not primary care physicians are actively managing intensive health care utilizations such as multiple hospital admissions and ED visits, as children prepare to enroll in hospice care. 11 Future research is clearly warranted.…”

“…9,10 The care they receive at end of life is often fragmented with high rates of hospital readmissions and emergency visits, while seldom utilizing hospice care. 11,12 Additionally, their end-of-life care is incredibly resource intensive and costly. 7 However, little is known about children in commercial insurance, and more than half of children have this coverage.…”

Children With Intellectual Disability and Hospice Utilization: The Moderating Effect of Residential Care

“…4 However, our recent research revealed that children with intellectual disability at end of life were less likely than their peers to enroll in hospice care and when they did, the average length of stay was only a day. 5,6 Identifying the barriers and facilitators to hospice care is important to ensure that children with intellectual disability receive high-quality end-of-life care.…”

Application of Instrumental Variable Analysis in Pediatric End-of-Life Research: A Case Study

“…However, applications to pediatric research are still scarce. 10 This article aims to introduce IVA and demonstrate its suitability for pediatric end-of-life research.…”