Journal article
Differences in Advance Care Planning and Circumstances of Death for Pediatric Patients Who Do and Do Not Receive Palliative Care Consults: A Single-Center Retrospective Review of All Pediatric Deaths from 2012 to 2016
Journal of palliative medicine, Vol.22(12), pp.1506-1514
12/01/2019
DOI: 10.1089/jpm.2019.0111
PMCID: PMC6998041
PMID: 31233350
Abstract
Background: Growing evidence suggests that pediatric palliative care (PPC) teams influence the care received by children and young adults with chronic, life-limiting illnesses. Little is known about how PPC involvement affects advance care planning (ACP) and circumstances of death in pediatric populations with a wide range of diagnoses. Objective: To determine the relationship between PPC involvement, ACP, and circumstances of death for pediatric patients. Design: A retrospective chart review of 558 pediatric patients who died between January 1, 2012 and December 31, 2016 was conducted. Descriptive statistics were used to characterize the sample. A multivariable logistic regression was used to obtain associations between PPC involvement and ACP. Setting: Large, multidisciplinary tertiary care center in a rural state. Measurements: Data abstracted for each patient included the following: demographic information, diagnosis, location of primary unit, hospice involvement, goals of care (GOC), code status, Physician Orders for Life-Sustaining Treatment (POLST) completion, and location of death. Results: Patients with PPC involvement were more likely to have had ACP addressed before death. After adjusting for covariates in the model, patients with PPC were more likely to have their GOC documented (odds ratio [OR] = 96.93), completion of POLST (OR = 24.06), do-not-resuscitate code status (OR = 7.71), and hospice involvement at the time of death (OR = 11.70) compared with those who did not receive PPC. Conclusions: Pediatric patients are more likely to have ACP addressed if they have PPC involvement. Patients with chronic complex conditions are most likely to receive palliative care.
Details
- Title: Subtitle
- Differences in Advance Care Planning and Circumstances of Death for Pediatric Patients Who Do and Do Not Receive Palliative Care Consults: A Single-Center Retrospective Review of All Pediatric Deaths from 2012 to 2016
- Creators
- Kathryn Harmoney - University of Rochester Medical CenterErin M. Mobley - University of IowaStephanie Gilbertson-White - University of IowaNicole K. Brogden - University of IowaRebecca J. Benson - Stead Family Division of General Pediatrics and Adolescent Medicine, Stead Family Department of Pediatrics, University of Iowa Healthcare, Iowa City, Iowa.
- Resource Type
- Journal article
- Publication Details
- Journal of palliative medicine, Vol.22(12), pp.1506-1514
- Publisher
- Mary Ann Liebert, Inc
- DOI
- 10.1089/jpm.2019.0111
- PMID
- 31233350
- PMCID
- PMC6998041
- ISSN
- 1096-6218
- eISSN
- 1557-7740
- Number of pages
- 9
- Grant note
- T32 CA009492; P30 CA086862 / NCI NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) P30CA086862 / NATIONAL CANCER INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI)
- Language
- English
- Date published
- 12/01/2019
- Academic Unit
- Dermatology; Health Management and Policy; Stead Family Department of Pediatrics; Pharmaceutical Sciences and Experimental Therapeutics; Nursing; Internal Medicine; General Pediatrics and Adolescent Medicine
- Record Identifier
- 9984296215002771
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