End-of-Life Care for Hispanic Children

Lindley, Lisa C.; Trujillo, Laura V.

doi:10.1177/1540415316670900

Cited by 10 publications

(15 citation statements)

References 19 publications

(28 reference statements)

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“…For those children who do enroll in hospice, a cardiac diagnosis is associated with a very short length of stay in hospice care 8 . This trend was consistent among children with cardiac disease including infants, 10 adolescents, 11 Hispanic children, 12 and commercially insured children 6 …”

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confidence: 77%

A National Study of Healthcare Service Patterns at the End of Life Among Children With Cardiac Disease

et al. 2021

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Background: Heart diseases are one of the leading causes of health-related deaths among children. Concurrent hospice care offers hospice and nonhospice healthcare services simultaneously, but the use of these services by children with cardiac disease has been rarely investigated. Objective: The aims of this study were to identify patterns of nonhospice healthcare services used in concurrent hospice care and describe the profile of children with cardiac disease in these clusters. Methods: This study was a retrospective cohort analysis of Medicaid claims data collected between 2011 and 2013 from 1635 pediatric cardiac patients. The analysis included descriptive statistics and latent class analysis. Results: Children in the sample used more than 314 000 nonhospice healthcare services. The most common services were inpatient hospital procedures, durable medical equipment, and home health. Latent class analysis clustered children into "moderate intensity" (60.0%) and "high intensity" classes (40.0%). Children in "moderate intensity" had dysrhythmias (31.7%), comorbidities (85.0%), mental/behavioral health conditions (55%), and technology dependence (71%). They commonly resided in urban areas (60.1%) in the Northeast (44.4%). The health profile of children in the "high intensity" class included dysrhythmias (39.4%), comorbidities (97.6%), mental/behavioral health conditions (71.5%), and technology dependence (85.8%). These children resided in rural communities (50.7%) in the South (53.1%). Conclusions: Two patterns of use of nonhospice healthcare services were identified in this study. This information may be used by nurses and other healthcare professionals working in concurrent hospice care to assess the healthcare service needs of children with cardiac conditions at the end of life.

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confidence: 77%

A National Study of Healthcare Service Patterns at the End of Life Among Children With Cardiac Disease

et al. 2021

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“…Sendo assim, fazse necessário que as equipes multiprofissionais, bem como todos os acompanhantes e familiares envolvidos no cuidado às crianças e adolescentes, recebam treinamento sobre do assunto. 14 Ademais, é de grande relevância a instalação de protocolos sobre cuidados paliativos em instituições de saúde. 14,15…”

Section: Abordagem Temática I -O Significado Do Treinamento No Campo Dos Cuidados Paliativosunclassified

“…14 Ademais, é de grande relevância a instalação de protocolos sobre cuidados paliativos em instituições de saúde. 14,15…”

Section: Abordagem Temática I -O Significado Do Treinamento No Campo Dos Cuidados Paliativosunclassified

Assistência à saúde em pediatria: uma revisão integrativa sobre os cuidados paliativos

et al. 2020

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Introdução: Cuidado Paliativo é uma abordagem que promove qualidade de vida tanto dos pacientes que enfrentam doenças que ameacem a continuidade da vida, quando de seus familiares, por meio de aspectos da prevenção e alívio do sofrimento, requerendo a identificação precoce, avaliação e tratamento da dor. Pode ser realizado em diversos cenários, inclusive em pediatria. Objetivo: analisar artigos científicos disseminados em periódicos on-line acerca da temática cuidados paliativos em pediatria. Método: revisão integrativa da literatura, com coleta de dados no mês de agosto de 2020, nas bases de dados LILACS, SCIELO, MEDLINE/PubMed, IBECS. Resultados: foram selecionadas 14 publicações, cujas analises textuais permitiram a construção de quatro abordagens temáticas: o significado do treinamento no campo dos cuidados paliativos; cuidados paliativos e luto; a espiritualidade e o paciente sob cuidados paliativos e cuidados paliativos e aspectos éticos. Conclusão: estudo verificou a relevância das dimensões do cuidado paliativo em pediatria durante a assistência e a necessidade do desenvolvimento de novos estudos para disseminar conhecimento sobre o tema.

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“…3 Among children in hospice care, studies have shown that approximately 90% of children qualified for Medicaid because of their health status. 4,5 Medicaid administration is complicated by federal laws, Medicaid waivers, state-specific Medicaid programs, and other specialized Medicaid programs requiring additional diagnostic or financial eligibility (Figure 1). Specific to end of life, the federal 2010 Patient Protection and Affordable Care Act (ACA, section 2302) enables pediatric Medicaid/CHIP beneficiaries to receive hospice care along with curative services for their life-limiting illness.…”

Section: Introductionmentioning

confidence: 99%

“…3 Among children in hospice care, studies have shown that approximately 90% of children qualified for Medicaid because of their health status. 4,5…”

Section: Introductionmentioning

confidence: 99%

Unraveling EPSDT and Pediatric Hospice Care: An Exploratory Policy Analysis

Lindley

Weaver

2022

Am J Hosp Palliat Care

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Background: Medicaid is the most common of health care benefits for children at end of life. Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) presents a complex policy scenario for children enrolled in the Medicaid hospice benefit, and specifically concurrent hospice care. Objective: The study purpose was to identify policy guidance on EPSDT and pediatric hospice care from state Medicaid documents. Methods: We conducted a descriptive exploratory study, using state-level Medicaid hospice documents. Manuals, policy transmittals, provider memos, policy updates, and other related documents were searched from 50 states and the District of Columbia. We created a comprehensive data extraction tool that enabled us to identify EPSDT-specific information. The appraisal of the documents was conducted under 3 main a priori themes: definitions, function, and administration. Results: Eleven states included EPSDT in their hospice documentation. Definitions for concurrent care and palliative care were sparse and inconsistent. Four states defined medically necessary criterion. Several states did not integrate EPSDT into the hospice or concurrent care benefit, while EPSDT functioned as part of the Medicaid hospice benefit in 3 states and another 4 included it in their concurrent hospice care program. Among all the states, procedures for EPSDT program administration varied widely, including care coordination and payment. Conclusion: We found significant variation in state documents on EPSDT and pediatric hospice care. Clear guidelines and consistent standards regarding EPSDT services and how they interface with hospice, concurrent hospice care, and palliative care would improve care for children and families.

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End-of-Life Care for Hispanic Children

Cited by 10 publications

References 19 publications

A National Study of Healthcare Service Patterns at the End of Life Among Children With Cardiac Disease

A National Study of Healthcare Service Patterns at the End of Life Among Children With Cardiac Disease

Assistência à saúde em pediatria: uma revisão integrativa sobre os cuidados paliativos

Unraveling EPSDT and Pediatric Hospice Care: An Exploratory Policy Analysis

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