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A National Study of Healthcare Service Patterns at the End of Life Among Children With Cardiac Disease

Lisa C Lindley, Radion Svynarenko, Kim Mooney-Doyle

    The Journal of Cardiovascular Nursing
    |December 22, 2021
    PubMed

    Insights

    This study identified two patterns of nonhospice healthcare service use in pediatric cardiac patients receiving concurrent hospice care. Understanding these patterns helps healthcare professionals tailor services for children with heart disease.

    Area of Science:

    • Pediatric Cardiology
    • Palliative Care
    • Health Services Research

    Background:

    • Heart disease is a leading cause of death in children.
    • Concurrent hospice care, combining hospice and nonhospice services, is understudied in pediatric cardiac patients.
    • Investigating service utilization is crucial for optimizing care.

    Purpose of the Study:

    • To identify patterns of nonhospice healthcare services used by children with cardiac disease in concurrent hospice care.
    • To characterize the patient profiles within identified service utilization clusters.
    • To inform healthcare professionals about service needs.

    Main Methods:

    • Retrospective cohort analysis of Medicaid claims data (2011-2013).
    • Included 1635 pediatric cardiac patients.
    • Utilized descriptive statistics and latent class analysis to identify service patterns.

    Main Results:

    • Over 314,000 nonhospice services were used, primarily inpatient procedures, durable medical equipment, and home health.
    • Latent class analysis revealed two clusters: 'moderate intensity' (60.0%) and 'high intensity' (40.0%).
    • Distinct patient profiles emerged regarding comorbidities, technology dependence, and geographic distribution.

    Conclusions:

    • Two distinct patterns of nonhospice healthcare service utilization were identified in pediatric cardiac patients receiving concurrent hospice care.
    • These findings provide valuable insights for healthcare providers to assess and meet the complex needs of these children.
    • This research supports improved care coordination and resource allocation in pediatric palliative cardiac care.
    Abstract

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