Intensity of Healthcare Utilization Among Pediatric Hospice Patients Receiving Concurrent Care

As children with life-threatening con- ditions near end-of-life, their disease burden and care requirements tend to increase, leading to high intensity of care in the hospital. Previous studies have examined patterns of healthcare usage among these children receiving hospice, but little is known about the impact of pediatric hospice involvement on healthcare utilization compared with usual care. We aimed to examine whether pediatric patients enrolled on concurrent hospice care utilize healthcare services at the same rate as prior to hospice enrollment.

A retrospective chart review examined deceased pediatric patients enrolled on the HopeHealth pediatric hospice between January 1, 2022 to December 31, 2023 who had received hospice care for more than seven days and who spent at least one day on hospice out of the hospital. We compared the number of hospital admissions and ICU days during the period between hospice enrollment and death (post-hospice) to the equivalent duration of time prior to hospice enrollment (pre-hospice).

All patients had fewer hospital days and PICU days post-hospice compared to pre-hospice. Nine patients had no hospital days following hospice enrollment, of which four had had zero hospital days prior to hospice enrollment Principal Conclusions: In this single-center study, patients receiving concurrent hospice care had fewer hospital days, ICU days, and invasive procedures compared to during the equivalent duration of time prior to hospice enrollment. Provision of hospice support alongside continued disease-directed care may lead to decreased inpatient admissions and interventions. More study is needed to better understand this potential correlation.