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Massachusetts' Pediatric Palliative Care Network: successful implementation of a novel state-funded pediatric

Kira Bona1, Jennifer Bates, Joanne Wolfe

  • 1Department of Medicine, Children's Hospital Boston, Boston, Massachusetts, USA.

Journal of Palliative Medicine
|August 10, 2011
PubMed

Insights

Massachusetts established a successful statewide pediatric palliative care network (PPCN) to support children with life-limiting illnesses, offering comprehensive services and demonstrating feasibility at low cost.

Area of Science:

  • Pediatric Palliative Care
  • Healthcare Program Implementation
  • Public Health Initiatives

Background:

  • Children with life-limiting illnesses face significant barriers to accessing palliative care in the U.S.
  • Massachusetts enacted a statute in 2006 to create and fund the Pediatric Palliative Care Network (PPCN).
  • The PPCN offers comprehensive community-based pediatric palliative care services through a network of licensed hospice programs.

Purpose of the Study:

  • To describe the implementation experience of a novel statewide pediatric palliative care program in Massachusetts.
  • To evaluate the services and outcomes of the Pediatric Palliative Care Network (PPCN).

Main Methods:

  • Utilized Massachusetts Department of Public Health administrative data to identify enrollment and service trends.
  • Summarized family satisfaction survey responses from enrolled families.
  • Analyzed service utilization and demographic data for children receiving care.

Main Results:

  • In FY2010, PPCN served 227 children through 11 hospice programs, with 86.7% of state funding allocated to direct hospice contracts.
  • Common diagnoses included cancer (30%), chromosomal abnormalities (17%), and neurodegenerative disorders (15%).
  • 100% of deaths occurred at the family's requested location, with a median length of stay of 233 days; psychosocial, case management, complementary therapies, and volunteer services were most utilized.

Conclusions:

  • The implementation of a statewide pediatric palliative care program, as demonstrated by the Massachusetts model, is highly feasible.
  • This innovative program can be achieved at a relatively low cost.
  • The PPCN model provides a successful framework for enhancing palliative care access for children with life-limiting illnesses.
Abstract

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