Profit Status and Delivery of Hospice Care for Infants: The Mediating Role of Pediatric Knowledge

Lindley, Lisa C.; Mixer, Sandra J; Mack, Jennifer W.

doi:10.1089/jpm.2012.0214

Cited by 7 publications

(4 citation statements)

References 22 publications

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“…Alternatively, hospices may have the ability to provide care to older children. Hospices may have adult equipment and supplies readily available that can be used in the care of these older children (Orloff, ), and their staff (i.e., nurses, physicians) may be able to translate their knowledge of adult hospice care to this age group more easily, as compared with toddlers and infants (Lindley, Mixer, & Mack, ). Future research might continue to explore the differences in hospice use among age groups.…”

Section: Discussionmentioning

confidence: 99%

Who are the children using hospice care?

Lindley

Shaw

2014

Specialist Pediatric Nursing

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Purpose The purpose was to examine the characteristics of children who use hospice care. Design and Methods Using the Andersen Model of Health Services Use, California Medicaid administrative databases were analyzed to describe the characteristics of 76 children in hospice. Results The predisposing, enabling, and need characteristics of children were identified. Children who used hospice were a diverse group with community resources that enable them to access care, while presenting with serious health needs. Children enrolled in hospice were more likely older (15–20 years of age), resided nearer a pediatric hospice, and had a serious health condition such as neuromuscular disease with multiple comorbidities. Practice Implications With this knowledge, pediatric nurses can improve their clinical practice by targeting conversations with families and children most in need of hospice care.

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Section: Discussionmentioning

confidence: 99%

Who are the children using hospice care?

Lindley

Shaw

2014

Specialist Pediatric Nursing

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“…This finding is inconsistent with reports that adult hospices will not enroll children because the staff are uncomfortable caring for children, especially infants. 23,24 While the adult hospice staff are often uncomfortable and unknowledgeable about caring for infants, 25 adult hospices may have utilized approaches to either increase staff training in pediatric care or partner with pediatric primary care providers or children's hospital staff to ensure infants can return home to die. 5 This study had several limitations.…”

Section: Discussionmentioning

confidence: 99%

Understanding Adult Hospices Caring for Children in California, 2018-2021

Davis,

Weaver,

Torkildson

et al. 2023

Am J Hosp Palliat Care

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In areas where there are absences of pediatric hospice care, adult hospices are often asked to provide hospice care for children. Little is known about these adult hospices. The purpose of our study was to describe the characteristics of adult hospices in California that provided care to children from 2018 to 2021. Using public data from the California Home Health Agencies and Hospice Annual Utilization Report, we conducted a longitudinal, retrospective descriptive study to examine the effects of hospice characteristics on adult hospices which provide care to children. Market, mission, operational, and financial characteristics were measured via the California utilization data using descriptive statistics. Service area was measured via latitude and longitude public data. Hospice location maps were generated for year 2018 and year 2021. The 148 hospices in the study had distinct organizational profiles, mainly small, with broad service coverage areas, in rural and urban communities with predominantly nurses visiting children. There was a significant decline (32%) in availability of adult hospices caring for children between 2018 and 2021, particularly in northern California. Hospice economics, lack of familiarity with Medicaid, and staff comfortability with caring for children in hospice, were not driving this decline. Our study provides critical insight into the characteristics of adult hospices in California providing care for children and has important policy implications.

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“…Despite these complex challenges across the system of home-based care, existing studies on the barriers and strategies to improve home-based care for children with serious illness focus on one or two levels of the system, such as the impact of provider knowledge or attitudes on home hospice or palliative care provision [ 17 , 18 , 19 , 20 , 21 ] or the effect of organizational and regulatory factors on care access [ 10 , 22 , 23 , 24 , 25 , 26 , 27 ]. Other studies have examined health system-level influences (e.g., care coordination, palliative care services) on patient and family quality of life [ 28 , 29 , 30 ], mental health [ 31 ], concordance between the preferred and actual location of death [ 32 , 33 , 34 ], and experiences and satisfaction with care [ 32 , 35 , 36 , 37 , 38 , 39 ].…”

Section: Introductionmentioning

confidence: 99%

Home-Based Care for Children with Serious Illness: Ecological Framework and Research Implications

et al. 2022

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Care for U.S. children living with serious illness and their families at home is a complex and patchwork system. Improving home-based care for children and families requires a comprehensive, multilevel approach that accounts for and examines relationships across home environments, communities, and social contexts in which children and families live and receive care. We propose a multilevel conceptual framework, guided by Bronfenbrenner’s ecological model, that conceptualizes the complex system of home-based care into five levels. Levels 1 and 2 contain patient and family characteristics. Level 3 contains factors that influence family health, well-being, and experience with care in the home. Level 4 includes the community, including community groups, schools, and providers. Level 5 includes the broader regional system of care that impacts the care of children and families across communities. Finally, care coordination and care disparities transcend levels, impacting care at each level. A multilevel ecological framework of home-based care for children with serious illness and families can be used in future multilevel research to describe and test hypotheses about aspects of this system of care, as well as to inform interventions across levels to improve patient and family outcomes.

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Profit Status and Delivery of Hospice Care for Infants: The Mediating Role of Pediatric Knowledge

Abstract: Hospices may need to explore ways to direct resources toward assisting hospice staff members in gaining pediatric experience.

Cited by 7 publications

References 22 publications

Who are the children using hospice care?

Who are the children using hospice care?

Understanding Adult Hospices Caring for Children in California, 2018-2021

Home-Based Care for Children with Serious Illness: Ecological Framework and Research Implications

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