Community-based pediatric palliative care for health related quality of life, hospital utilization and costs lessons learned from a pilot study
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Jeffrey Goldhagen1, Mark Fafard2, Kelly Komatz1
1Division of Community and Societal Pediatrics, Department of Pediatrics, UF College of Medicine - Jacksonville, 841 Prudential Drive, Suite 1330 m, Jacksonville, FL, 32207, USA.
Insights
Community-Based Pediatric Palliative Care (CBPPC) improved health-related quality of life and reduced hospitalizations for children with complex conditions. This approach shows potential for better care and cost savings in pediatric healthcare.
Area of Science:
- Pediatric Healthcare
- Palliative Care
- Health Services Research
Background:
- Children with complex medical conditions represent a significant healthcare burden.
- Community-Based Pediatric Palliative Care (CBPPC) offers a holistic approach to improve quality of life and reduce healthcare costs.
- The Affordable Care Act emphasizes patient-centered outcomes, highlighting the need for such studies.
Purpose of the Study:
- To analyze unpublished evaluation data from 2007 on CBPPC.
- To assess the impact of CBPPC on Health-Related Quality of Life (HRQoL).
- To evaluate the effect of CBPPC on hospital utilization and associated costs.
Main Methods:
- A multi-method research design was employed.
- Caregiver data (n=53) were collected for HRQoL assessment.
- Administrative data (n=48) were used to analyze hospital utilization and costs.
Main Results:
- Health-Related Quality of Life (HRQoL) was generally high among participants.
- Hospital charges per child decreased by $1203 for total services (p=.34) and $1047 for diagnostic services (p=0.13).
- Hospital length of stay significantly decreased from 2.92 to 1.22 days per quarter (p<.05).
Conclusions:
- CBPPC demonstrates potential to positively impact key outcomes for children with complex medical conditions.
- Reduced hospital utilization and costs, coupled with high HRQoL, support the value of CBPPC.
- This approach can enhance the quality of care for children with complex needs and their families.
Background:
Children with chronic complex-medical conditions comprise a small minority of children who require substantial healthcare with major implications for hospital utilization and costs in pediatrics. Community-Based Pediatric Palliative Care (CBPPC) provides a holistic approach to patient care that can improve their quality of life and lead to reduced costs of hospital care. This study's purpose was to analyze and report unpublished evaluation study results from 2007 that demonstrate the potential for CBPPC on Health Related Quality of Life (HRQoL) and hospital utilization and costs in light of the increasing national focus on the care of children with complex-medical conditions, including the Affordable Care Act's emphasis on patient-centered outcomes.
Methods:
A multi-method research design used primary data collected from caregivers to determine the Program's potential impact on HRQoL, and administrative data to assess the Program's potential impact on hospital utilization and costs. Caregivers (n=53) of children enrolled in the Northeast Florida CBPPC program (Community PedsCare) through the years 2002-2007 were recruited for the Health Related Quality of Life (HRQoL) study. Children (n=48) enrolled in the Program through years 2000-2006 were included in the utilization and cost study.
Results:
HRQoL was generally high, and hospital charges per child declined by $1203 for total hospital services (p=.34) and $1047 for diagnostic charges per quarter (p=0.13). Hospital length of stay decreased from 2.92 days per quarter to 1.22 days per quarter (p<.05).
Conclusion:
The decrease in hospital utilization and costs and the high HRQoL results indicate that CBPPC has the potential to influence important outcomes for the quality of care available for children with complex-medical conditions and their caregivers.
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