Home-Based Pediatric Hospice and Palliative Care Provider Visits: Effects on Healthcare Utilization
This hypothesis-generating study sought to assess the impact of home-based hospice and palliative care (HBHPC) provider home visits (HV) on healthcare use. Retrospective review of individuals ages 1 month to 21 years receiving an in-person HBHPC provider (MD/DO or APN) HV through 2 HBHPC programs in...
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| Veröffentlicht in: | The Journal of pediatrics 2024-05, Vol.268, p.113929-113929, Article 113929 |
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| container_title | The Journal of pediatrics |
| container_volume | 268 |
| creator | Smith, Steven M. Grossoehme, Daniel H. Cicozi, Kate Hiltunen, Audrey Roth, Catherine Richner, Gwendolyn Kim, Stephani S. Tram, Nguyen K. Friebert, Sarah |
| description | This hypothesis-generating study sought to assess the impact of home-based hospice and palliative care (HBHPC) provider home visits (HV) on healthcare use.
Retrospective review of individuals ages 1 month to 21 years receiving an in-person HBHPC provider (MD/DO or APN) HV through 2 HBHPC programs in the Midwest from January 1, 2013, through December 31, 2018. Descriptive statistics were calculated for healthcare use variables. Paired t test or Wilcoxon signed-rank test compared the changes in healthcare use the year before and year after initial provider HVs.
The cohort included 195 individuals (49% female), with diagnoses composed of 49% neurologic, 30% congenital chromosomal, 11% oncologic, 7% cardiac, and 3% other. After implementation of HBHPC services, these patients showed decreases in the median (IQR) number of intensive care unit days (before HV, 12 [IQR, 4-37]; after HV, 0 [IQR, 0-8]; P |
| doi_str_mv | 10.1016/j.jpeds.2024.113929 |
| format | Article |
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Retrospective review of individuals ages 1 month to 21 years receiving an in-person HBHPC provider (MD/DO or APN) HV through 2 HBHPC programs in the Midwest from January 1, 2013, through December 31, 2018. Descriptive statistics were calculated for healthcare use variables. Paired t test or Wilcoxon signed-rank test compared the changes in healthcare use the year before and year after initial provider HVs.
The cohort included 195 individuals (49% female), with diagnoses composed of 49% neurologic, 30% congenital chromosomal, 11% oncologic, 7% cardiac, and 3% other. After implementation of HBHPC services, these patients showed decreases in the median (IQR) number of intensive care unit days (before HV, 12 [IQR, 4-37]; after HV, 0 [IQR, 0-8]; P < .001); inpatient admissions (before HV, 1 [IQR, 1-3]; after HV, 1 [IQR, 0-2]; P = .005); and number of inpatient days (before HV, 5 [IQR, 1-19]; after HV, 2 [IQR, 0-8]; P = .009). There was an increase in clinically relevant phone calls to the HBHPC team (before HV, 1 [IQR, 0-4] vs after HV, 4 [IQR, 1-7]; P < .001) and calls to the HBHPC team before emergency department visits (before HV, 0 [IQR, 0-0] vs after HV, 1 [IQR, 1-2]; P < .001).
HBHPC provider HVs were associated with fewer inpatient admissions, hospital days, and intensive care unit days, and increased clinically relevant phone calls and phone calls before emergency department visit. These findings indicate that HBHPC HV may contribute to decreased inpatient use and increased use of the HBHPC team.</description><identifier>ISSN: 0022-3476</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/j.jpeds.2024.113929</identifier><identifier>PMID: 38309523</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Child ; Child, Preschool ; Children with Medical ; Complexity ; Female ; Home Care Services - statistics & numerical data ; Home-Based Palliative Care ; Homecare ; Hospice ; Hospice Care - statistics & numerical data ; Hospital Resource Utilization ; House Calls - statistics & numerical data ; Humans ; Infant ; Male ; Palliative Care - statistics & numerical data ; Patient Acceptance of Health Care - statistics & numerical data ; Pediatric Palliative Care ; Retrospective Studies ; Young Adult</subject><ispartof>The Journal of pediatrics, 2024-05, Vol.268, p.113929-113929, Article 113929</ispartof><rights>2024 The Author(s)</rights><rights>Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c354t-6bbc0fc77aed69b727da3d63276386281cf2d2a8506a4d6a5e793fcfecdee5b23</cites><orcidid>0000-0003-2119-2016</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jpeds.2024.113929$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38309523$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Smith, Steven M.</creatorcontrib><creatorcontrib>Grossoehme, Daniel H.</creatorcontrib><creatorcontrib>Cicozi, Kate</creatorcontrib><creatorcontrib>Hiltunen, Audrey</creatorcontrib><creatorcontrib>Roth, Catherine</creatorcontrib><creatorcontrib>Richner, Gwendolyn</creatorcontrib><creatorcontrib>Kim, Stephani S.</creatorcontrib><creatorcontrib>Tram, Nguyen K.</creatorcontrib><creatorcontrib>Friebert, Sarah</creatorcontrib><title>Home-Based Pediatric Hospice and Palliative Care Provider Visits: Effects on Healthcare Utilization</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>This hypothesis-generating study sought to assess the impact of home-based hospice and palliative care (HBHPC) provider home visits (HV) on healthcare use.
Retrospective review of individuals ages 1 month to 21 years receiving an in-person HBHPC provider (MD/DO or APN) HV through 2 HBHPC programs in the Midwest from January 1, 2013, through December 31, 2018. Descriptive statistics were calculated for healthcare use variables. Paired t test or Wilcoxon signed-rank test compared the changes in healthcare use the year before and year after initial provider HVs.
The cohort included 195 individuals (49% female), with diagnoses composed of 49% neurologic, 30% congenital chromosomal, 11% oncologic, 7% cardiac, and 3% other. After implementation of HBHPC services, these patients showed decreases in the median (IQR) number of intensive care unit days (before HV, 12 [IQR, 4-37]; after HV, 0 [IQR, 0-8]; P < .001); inpatient admissions (before HV, 1 [IQR, 1-3]; after HV, 1 [IQR, 0-2]; P = .005); and number of inpatient days (before HV, 5 [IQR, 1-19]; after HV, 2 [IQR, 0-8]; P = .009). There was an increase in clinically relevant phone calls to the HBHPC team (before HV, 1 [IQR, 0-4] vs after HV, 4 [IQR, 1-7]; P < .001) and calls to the HBHPC team before emergency department visits (before HV, 0 [IQR, 0-0] vs after HV, 1 [IQR, 1-2]; P < .001).
HBHPC provider HVs were associated with fewer inpatient admissions, hospital days, and intensive care unit days, and increased clinically relevant phone calls and phone calls before emergency department visit. These findings indicate that HBHPC HV may contribute to decreased inpatient use and increased use of the HBHPC team.</description><subject>Adolescent</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children with Medical</subject><subject>Complexity</subject><subject>Female</subject><subject>Home Care Services - statistics & numerical data</subject><subject>Home-Based Palliative Care</subject><subject>Homecare</subject><subject>Hospice</subject><subject>Hospice Care - statistics & numerical data</subject><subject>Hospital Resource Utilization</subject><subject>House Calls - statistics & numerical data</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Palliative Care - statistics & numerical data</subject><subject>Patient Acceptance of Health Care - statistics & numerical data</subject><subject>Pediatric Palliative Care</subject><subject>Retrospective Studies</subject><subject>Young Adult</subject><issn>0022-3476</issn><issn>1097-6833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LAzEQhoMotlZ_gSA5etk1H7vZXcGDlmqFgj1YryGbzGLKdlOTbUF_vamtHj0NDM87L_MgdElJSgkVN8t0uQYTUkZYllLKK1YdoSElVZGIkvNjNCSEsYRnhRigsxCWhJAqI-QUDXjJSZUzPkR66laQPKgABs_BWNV7q_HUhbXVgFUXt6pt49puAY-VBzz3bmsNePxmg-3DLZ40Deg-YNfhKai2f9c7bNHb1n7FnOvO0Umj2gAXhzlCi8fJ63iazF6ensf3s0TzPOsTUdeaNLooFBhR1QUrjOJGcFYIXgpWUt0ww1SZE6EyI1QORcUbHcsNQF4zPkLX-7tr7z42EHq5skFD26oO3CZIVrGyzHmZ0YjyPaq9C8FDI9ferpT_lJTInV25lD925c6u3NuNqatDwaZegfnL_OqMwN0egPjm1oKXQVvodBTroyNpnP234Bv9po0R</recordid><startdate>202405</startdate><enddate>202405</enddate><creator>Smith, Steven M.</creator><creator>Grossoehme, Daniel H.</creator><creator>Cicozi, Kate</creator><creator>Hiltunen, Audrey</creator><creator>Roth, Catherine</creator><creator>Richner, Gwendolyn</creator><creator>Kim, Stephani S.</creator><creator>Tram, Nguyen K.</creator><creator>Friebert, Sarah</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2119-2016</orcidid></search><sort><creationdate>202405</creationdate><title>Home-Based Pediatric Hospice and Palliative Care Provider Visits: Effects on Healthcare Utilization</title><author>Smith, Steven M. ; Grossoehme, Daniel H. ; Cicozi, Kate ; Hiltunen, Audrey ; Roth, Catherine ; Richner, Gwendolyn ; Kim, Stephani S. ; Tram, Nguyen K. ; Friebert, Sarah</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c354t-6bbc0fc77aed69b727da3d63276386281cf2d2a8506a4d6a5e793fcfecdee5b23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children with Medical</topic><topic>Complexity</topic><topic>Female</topic><topic>Home Care Services - statistics & numerical data</topic><topic>Home-Based Palliative Care</topic><topic>Homecare</topic><topic>Hospice</topic><topic>Hospice Care - statistics & numerical data</topic><topic>Hospital Resource Utilization</topic><topic>House Calls - statistics & numerical data</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>Palliative Care - statistics & numerical data</topic><topic>Patient Acceptance of Health Care - statistics & numerical data</topic><topic>Pediatric Palliative Care</topic><topic>Retrospective Studies</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Smith, Steven M.</creatorcontrib><creatorcontrib>Grossoehme, Daniel H.</creatorcontrib><creatorcontrib>Cicozi, Kate</creatorcontrib><creatorcontrib>Hiltunen, Audrey</creatorcontrib><creatorcontrib>Roth, Catherine</creatorcontrib><creatorcontrib>Richner, Gwendolyn</creatorcontrib><creatorcontrib>Kim, Stephani S.</creatorcontrib><creatorcontrib>Tram, Nguyen K.</creatorcontrib><creatorcontrib>Friebert, Sarah</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Smith, Steven M.</au><au>Grossoehme, Daniel H.</au><au>Cicozi, Kate</au><au>Hiltunen, Audrey</au><au>Roth, Catherine</au><au>Richner, Gwendolyn</au><au>Kim, Stephani S.</au><au>Tram, Nguyen K.</au><au>Friebert, Sarah</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Home-Based Pediatric Hospice and Palliative Care Provider Visits: Effects on Healthcare Utilization</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>2024-05</date><risdate>2024</risdate><volume>268</volume><spage>113929</spage><epage>113929</epage><pages>113929-113929</pages><artnum>113929</artnum><issn>0022-3476</issn><eissn>1097-6833</eissn><abstract>This hypothesis-generating study sought to assess the impact of home-based hospice and palliative care (HBHPC) provider home visits (HV) on healthcare use.
Retrospective review of individuals ages 1 month to 21 years receiving an in-person HBHPC provider (MD/DO or APN) HV through 2 HBHPC programs in the Midwest from January 1, 2013, through December 31, 2018. Descriptive statistics were calculated for healthcare use variables. Paired t test or Wilcoxon signed-rank test compared the changes in healthcare use the year before and year after initial provider HVs.
The cohort included 195 individuals (49% female), with diagnoses composed of 49% neurologic, 30% congenital chromosomal, 11% oncologic, 7% cardiac, and 3% other. After implementation of HBHPC services, these patients showed decreases in the median (IQR) number of intensive care unit days (before HV, 12 [IQR, 4-37]; after HV, 0 [IQR, 0-8]; P < .001); inpatient admissions (before HV, 1 [IQR, 1-3]; after HV, 1 [IQR, 0-2]; P = .005); and number of inpatient days (before HV, 5 [IQR, 1-19]; after HV, 2 [IQR, 0-8]; P = .009). There was an increase in clinically relevant phone calls to the HBHPC team (before HV, 1 [IQR, 0-4] vs after HV, 4 [IQR, 1-7]; P < .001) and calls to the HBHPC team before emergency department visits (before HV, 0 [IQR, 0-0] vs after HV, 1 [IQR, 1-2]; P < .001).
HBHPC provider HVs were associated with fewer inpatient admissions, hospital days, and intensive care unit days, and increased clinically relevant phone calls and phone calls before emergency department visit. These findings indicate that HBHPC HV may contribute to decreased inpatient use and increased use of the HBHPC team.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38309523</pmid><doi>10.1016/j.jpeds.2024.113929</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0003-2119-2016</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0022-3476 |
| ispartof | The Journal of pediatrics, 2024-05, Vol.268, p.113929-113929, Article 113929 |
| issn | 0022-3476 1097-6833 |
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| subjects | Adolescent Child Child, Preschool Children with Medical Complexity Female Home Care Services - statistics & numerical data Home-Based Palliative Care Homecare Hospice Hospice Care - statistics & numerical data Hospital Resource Utilization House Calls - statistics & numerical data Humans Infant Male Palliative Care - statistics & numerical data Patient Acceptance of Health Care - statistics & numerical data Pediatric Palliative Care Retrospective Studies Young Adult |
| title | Home-Based Pediatric Hospice and Palliative Care Provider Visits: Effects on Healthcare Utilization |
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