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This summary is machine-generated.

Most children with complex conditions received goal-concordant end-of-life (EOL) care. However, Black children experienced more discordant EOL care, highlighting disparities in pediatric palliative care.

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Area of Science:

  • Pediatric complex chronic conditions
  • End-of-life care delivery
  • Healthcare disparities

Background:

  • Children with complex chronic conditions often require intensive medical care.
  • End-of-life (EOL) care aims to align with patient and family goals.
  • Goal-concordant EOL care is crucial for quality of life in pediatric patients.

Purpose of the Study:

  • To characterize the delivery of goal-concordant end-of-life (EOL) care for children with complex chronic conditions.
  • To identify factors associated with goal-concordance in pediatric EOL care.

Main Methods:

  • Retrospective review of goals of care discussions for 272 children with complex chronic conditions who died at a tertiary hospital.
  • Assessment of goals of care and code status before and within 72 hours of death.
  • Coding of discussions into categories: full interventions, considering palliation, planned transition to palliation, or active transition to palliation.

Main Results:

  • 82.2% of children with documented goals of care received goal-concordant EOL care.
  • Black children had over 8 times higher odds of receiving goal-discordant care compared to White children.
  • Significant shift towards palliation and Do Not Resuscitate (DNR) status in the final 72 hours of life.

Conclusions:

  • The majority of children with complex conditions received goal-concordant EOL care.
  • Significant racial disparities exist, with Black children facing higher rates of discordant care.
  • EOL care planning effectively shifted towards palliation in the final days of life.