Healthcare Utilization in Pediatric Cancer Patients Near the End-of-Life

Area of Science:

• Pediatric Oncology
• Palliative Care
• Healthcare Utilization

Background:

• End-of-life care for pediatric cancer patients involves complex healthcare decisions.
• Understanding healthcare utilization patterns is crucial for supporting patients and families.

Purpose of the Study:

• To compare healthcare utilization in the final 60 days of life for pediatric cancer patients who died at home under hospice care versus those who died in a hospital setting.

Main Methods:

• Retrospective chart review of medical records.
• Inclusion criteria: pediatric patients with a cancer diagnosis, palliative care consult, and death either at home under hospice or in the hospital.

Main Results:

• Patients under hospice care at home spent a median of 44 days at home.
• Hospital deaths involved a median of 30.5 days in the hospital, 10.5 days in intensive care, and 3.5 procedures requiring anesthesia.
• Compassionate extubation occurred in 45% of hospital deaths.

Conclusions:

• Hospice care at home allows pediatric cancer patients significant time at home with minimal healthcare utilization.
• Hospital deaths are associated with substantial hospital and intensive care unit days, and invasive procedures.
• Findings provide valuable insights for providers and families regarding end-of-life healthcare utilization in pediatric cancer.