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Pediatric Home-Based Palliative Care and Hospice: Characterizing and Comparing the Populations
Ben Reader1, Sibelle Aurelie Yemele Kitio2, Steven M Smith3
1Division of Homecare (B.R., S.M.S.), Nationwide Children's Hospital, Columbus, Ohio, USA.
Journal of Pain and Symptom Management
|September 12, 2025
Summary
Home-based palliative care (HBPC) and hospice programs serve children with life-shortening conditions. Hospice patients were younger, had more cancer diagnoses, and higher mortality than HBPC patients.
Area of Science:
- Pediatric Palliative Care
- Healthcare Services Research
Background:
- Home-based palliative care (HBPC) and hospice programs support children with complex, life-shortening conditions.
- Limited comparative data exist on the characteristics and care trajectories of pediatric HBPC versus hospice patients.
Purpose of the Study:
- To compare the characteristics of pediatric patients receiving HBPC and/or hospice.
- To identify differences and similarities between these pediatric populations.
Main Methods:
- Retrospective cohort study of 113 children (birth-21 years) receiving HBPC and/or hospice between 2019-2022.
- Data extracted from electronic health records; statistical analyses included descriptive statistics and comparative tests.
- Subgroup analyses excluded children under 1 year.
Main Results:
- Hospice recipients were younger (median 2 vs. 7 years), more likely to have oncologic diagnoses, and had higher mortality (69.6% vs. 22.1%).
- HBPC patients had more hospital admissions, longer inpatient stays, and more outpatient visits.
- Among children ≥1 year, hospice patients were more likely to have 'allow natural death' orders and code status changes.
Conclusions:
- Significant differences exist between pediatric HBPC and hospice populations regarding age, diagnosis, and healthcare utilization.
- These findings highlight distinct profiles and needs within pediatric palliative care settings.
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