Impact of Concurrent Hospice Care on Primary Care Visits Among Children in Rural Southern Appalachia

Fornehed, Mary Lou Clark; Svynarenko, Radion; Lindley, Lisa C.

doi:10.1016/j.pedhc.2022.05.005

Cited by 2 publications

(3 citation statements)

References 26 publications

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“…21 Among a subset of children in rural, southern Appalachia, concurrent care was found to be twice as effective as standard care in retaining engagement with the primary care physician. 22 The results suggested that concurrent care provided health care consistent with the inclusion of primary care. Holistically, the clinical effectiveness of concurrent hospice care may surpass standard hospice care in ensuring a higher standard of quality of end of life for children and their families.…”

Section: Long-term Effectivenessmentioning

confidence: 92%

“…Recent evidence suggests that in Appalachia, rural versus urban children continued to visit their primary care provider (50% vs. 31%, respectively) during hospice admission 21 . Among a subset of children in rural, southern Appalachia, concurrent care was found to be twice as effective as standard care in retaining engagement with the primary care physician 22 . The results suggested that concurrent care provided health care consistent with the inclusion of primary care.…”

Section: Conceptual Modelmentioning

confidence: 95%

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Conceptualizing the Value of Pediatric Concurrent Hospice Care

Sharp

Svynarenko

Fornehed

et al. 2022

J Hosp Palliat Nurs

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Given that pediatric concurrent hospice care has been available for more than a decade, it is appropriate to seek an understanding of the value of this care delivery approach. Value is the cost associated with achieving beneficial health outcomes. In pursuit of this goal, the current literature on pediatric concurrent hospice care was synthesized and used to develop a model to explain its value. Because of its relevance, the Value Assessment Framework was used to conceptualize the value of pediatric concurrent hospice care. This framework gauges the value of a health care service through 2 components: long-term effect and short-term affordability. The framework considers comparative clinical effectiveness, cost-effectiveness, other benefits or disadvantages, contextual considerations, and potential budget impact. Evidence from the literature suggested that the value of concurrent care depended on clinical outcomes evaluated, costs examined, medical services used, care coordinated, context considered, and budget impacted. The literature demonstrated that pediatric concurrent hospice care does offer significant value for children and their families. The conceptual model highlighted the need for a comprehensive approach to assessing value. The model is a useful framework for future research examining the value of concurrent hospice care.

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Section: Long-term Effectivenessmentioning

confidence: 92%

Section: Conceptual Modelmentioning

confidence: 95%

Conceptualizing the Value of Pediatric Concurrent Hospice Care

Sharp

Svynarenko

Fornehed

et al. 2022

J Hosp Palliat Nurs

Self Cite

View full text Add to dashboard Cite

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“…[22][23][24] The latter was defined as receiving non-hospice care at the time of hospice enrollment. 25 In addition, concurrent and standard hospice care are clear dichotomies, but are not mutually exclusive in time. The same child enrolled in Medicaid could receive either concurrent or standard hospice care at different time points of their Medicaid enrollment.…”

Section: Methodsmentioning

confidence: 99%

A Comparison of Hospice Care Utilization Between Rural and Urban Children in Appalachia: A Geographic Information Systems Analysis

Svynarenko

Huang

Keim‐Malpass

et al. 2023

Am J Hosp Palliat Care

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Long driving times from hospice providers to patients lead to poor quality of care, which may exacerbate in rural and highly isolated areas of Appalachia. This study aimed to investigate geographic patterns of pediatric hospice care across Appalachia. Using person-level Medicaid claims of 1,788 pediatric hospice enrollees who resided in the Appalachian Region between 2011 and 2013. A database of boundaries of Appalachian counties, postal addresses of hospices, and population-weighted county centroids of residences of hospice enrollees driving times from the nearest hospices were calculated. A choropleth map was created to visualize rural/urban differences in receiving hospice care. The average driving time from hospice to child residence was 28 minutes (SD = 26). The longest driving time was in Eastern Kentucky—126 minutes (SD = 32), and the shortest was in South Carolina—11 min (SD = 9.1). The most significant differences in driving times between rural and urban counties were found in Virginia 28 (SD = 7.5) and 5 minutes (SD = 0), respectively, Tennessee—43 (SD = 28) and 8 minutes (SD = 7), respectively; and West Virginia—49 (SD = 30) and 12 minutes (SD = 4), respectively. Many pediatric hospice patients reside in isolated counties with long driving times from the nearest hospices. State-level policies should be developed to reduce driving times from hospice providers.

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Impact of Concurrent Hospice Care on Primary Care Visits Among Children in Rural Southern Appalachia

Cited by 2 publications

References 26 publications

Conceptualizing the Value of Pediatric Concurrent Hospice Care

Conceptualizing the Value of Pediatric Concurrent Hospice Care

A Comparison of Hospice Care Utilization Between Rural and Urban Children in Appalachia: A Geographic Information Systems Analysis

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