Differences in service utilization between pediatric and adult palliative care services in a single center

Area of Science:

• Palliative Care
• Pediatric Healthcare
• Oncology-Free Patient Care

Background:

• Current palliative care (PC) recommendations lack differentiation for adult and pediatric needs.
• Existing guidelines do not specify personnel requirements or care distribution between community and hospital settings for pediatric versus adult PC.
• There is a need to understand the distinct utilization patterns of hospital-based PC services for non-oncology adult and pediatric patients.

Purpose of the Study:

• To evaluate the differences in the utilization of hospital-based palliative care (PC) services between adult and pediatric non-oncology patients.
• To identify key demographic and clinical factors influencing PC service utilization in these distinct populations.

Main Methods:

• A retrospective study was conducted on non-oncology patients seen by adult or pediatric PC teams.
• Data collected included demographics, diagnoses, consultation frequency, duration of PC involvement, and follow-up.
• The study period spanned June 2021 to July 2023 at a single tertiary hospital.

Main Results:

• 445 adults and 48 children received PC services.
• Adults typically had common chronic diseases with high in-hospital mortality.
• Children, often younger with rare diseases, required longer PC follow-up (114 vs. 5 days) and more consultations (8.5 vs. 4), with lower in-hospital mortality (25% vs. 61.6%).

Conclusions:

• Adult PC patients often present with common chronic illnesses managed by primary care.
• Pediatric PC patients frequently have rare, complex life-limiting diseases requiring specialized, hospital-based services.
• Future PC planning must consider these differences, advocating for enhanced training for adult primary care practitioners and earlier hospital-based PC referrals for pediatric patients.