Factors Associated With the Provision of Hospice Care for Children

Abstract

Context Children at end of life often lack access to hospice care at home or in a dedicated facility. The factors that may influence whether or not hospices provide pediatric care are relatively unknown. Objectives The purpose of this study was to understand the institutional and resource factors associated with provision of pediatric hospice care. Methods This study used a retrospective, longitudinal design. The main data source was the 2002 to 2008 California State Hospice Utilization Data Files. The sample size was 311 hospices or 1368 hospice observations over seven years. Drawing on institutional and resource dependence theory, this study used generalized estimating equations to examine the institutional and resource factors associated with provision of pediatric hospice care. Interaction terms were included to assess the moderating effect of resource factors on the relationship between institutional factors and provision of care. Results Membership in professional groups increased the probability (19%) of offering hospice services for children. Small- (−22%) and medium-sized (−11%) hospices were less likely to provide care for children. The probability of providing pediatric hospice care diminished (−23%) when competition increased in the prior year. Additionally, small size attenuated the accreditation-provision relationship and medium size magnified the membership-provision relationship. Conclusion Professional membership may promote conformity to industry standards of pediatric care and remove the unknowns of providing hospice care for children. Hospices, especially medium-sized hospices, interested in developing or expanding care for children may benefit by identifying a pediatric champion to join a professional group.

A Profile of Children with Complex Chronic Conditions at End of Life among Medicaid Beneficiaries: Implications for Health Care Reform

“…Our previous research has shown that approximately two-thirds of California hospices and home health agencies do not provided pediatric EOL care, and the percentage of agencies providing care for children has declined from 40% in 2002 to 28% in 2008. 31 Thus, children with CCCs may not be receiving highquality EOL care. Future research design should explore and clarify the influence of child demographic and health characteristics on EOL care utilization.…”

Organizational and environmental correlates of the adoption of a focus strategy in U.S. hospices

“…In accordance with extant literature, munificence was operationalized using organizational size measured as patient census (Lindley et al, 2013), county level per capita income (Hsieh, Clement, & Bazzoli, 2010;Kazley & Ozcan, 2007;Menachemi et al, 2011), and a measure of health care demand, the proportion of adults 65 years and older (Menachemi et al, 2011). Size was operationalized by the number of patients served by a hospice in the year (Lindley et al, 2013).…”

Pediatric Palliative Care and Hospice Care Commitments, Guidelines, and Recommendations

“…22,23 Despite steady growth in the hospice industry, recent evidence indicates that hospices willing to care for children are decreasing in number. 24 All hospices are encouraged to provide care to children to maintain a core level of competency; hospices caring for children should adhere to the National Hospice and Palliative Care Organization Standards of Practice for Pediatric Palliative Care and Hospice. 14,25…”