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Cost Analysis and Policy Implications of a Pediatric Palliative Care Program
Daphna Gans1, Max W Hadler2, Xiao Chen2
1David Geffen School of Medicine at UCLA, Los Angeles, California, USA; UCLA Center for Health Policy Research, Los Angeles, California, USA.
Journal of Pain and Symptom Management
|May 29, 2016
Summary
Partners for Children (PFC) significantly reduced healthcare costs for pediatric patients by shifting care from inpatient to home-based services. This pilot program demonstrated a cost-effective model for pediatric palliative care.
Area of Science:
- Healthcare Management
- Palliative Care Research
- Pediatric Health Services
Background:
- California's Partners for Children (PFC) program, launched in 2010, provided pediatric palliative care services concurrently with curative treatments.
- The program targeted children eligible for full-scope Medicaid, irrespective of life expectancy.
Purpose of the Study:
- To assess the impact of the PFC program on healthcare costs and utilization among pediatric enrollees.
- To compare healthcare costs and utilization metrics before and during PFC program participation.
Main Methods:
- A pre-post analysis was conducted using paid Medicaid claims and program enrollment data.
- Healthcare costs per enrollee per month (PEPM) and healthcare utilization (inpatient days, length of stay) were analyzed up to 24 months before and during program enrollment (January 2010 - December 2012).
Main Results:
- Average PEPM healthcare costs decreased by $3331, primarily due to a $4897 PEPM reduction in inpatient costs.
- Inpatient days per month decreased by nearly 50% (from 4.2 to 2.3), and the average length of stay per hospitalization reduced from 16.7 to 6.5 days.
Conclusions:
- The PFC program effectively reduced costs for children with life-limiting conditions by transitioning care from inpatient to coordinated outpatient and home-based services.
- PFC's home-based care model is a cost-effective strategy for pediatric palliative care, applicable in other settings.
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