Effectiveness of Pediatric Concurrent Hospice Care to Improve Continuity of Care.
Effectiveness of Pediatric Concurrent Hospice Care to Improve Continuity of Care.
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DOI：
10.1177/10499091211056039
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发表时间：
2022-10
影响因子：
1.9
通讯作者：
Hinds, Pamela S.
中科院分区：
文献类型：
--
作者：
Lindley, Lisa C.;Cozad, Melanie J.;Mack, Jennifer W.;Keim-Malpass, Jessica;Svynarenko, Radion;Hinds, Pamela S.
关键词：
2010年的《病人保护和平价医疗法案》（ACA）规定了具有里程碑意义的临终关怀立法。关于儿科并发临终关怀的影响知之甚少。本研究的目的是检查儿科并行与标准临终关怀对医疗补助受益人的临终关怀连续性的影响。使用国家医疗补助数据，我们进行了一项准实验设计的研究，以评估并行与标准临终关怀的效果，以提高儿童的临终关怀的连续性。护理连续性（即，临终关怀住院时间、临终关怀取消登记、急诊室过渡、住院过渡）通过索赔数据进行测量。暴露是并发临终关怀与标准临终关怀。使用工具变量分析，暴露对护理连续性的有效性进行了比较。并发临终关怀影响护理的连续性。与标准临终关怀相比，它导致临终关怀的住院时间更长（β = 2.76，p < 0.001），临终关怀的出院率更低（β =-2.80，p < 0.05）。在临终关怀招募期间，同期护理在减少急诊室（β = 2.09，p < 0.001）或住院护理（β = 0.007，p < 0.05）转换方面无效。我们的研究为儿童临终关怀的质量提供了重要的见解。这些发现具有政策意义。
The 2010 Patient Protection and Affordable Care Act (ACA) mandated landmark hospice care legislation for children at end of life. Little is known about the impact of pediatric concurrent hospice care. The purpose of this study was to examine the effect of pediatric concurrent versus standard hospice care on end-of-life care continuity among Medicaid beneficiaries. Using national Medicaid data, we conducted a quasi-experimental designed study to estimate the effect of concurrent versus standard hospice care to improve end-of-life care continuity for children. Care continuity (i.e., hospice length of stay, hospice disenrollment, emergency room transition, inpatient transition) were measured via claims data. Exposures were concurrent hospice versus standard hospice care. Using instrumental variable analysis, the effectiveness of exposures on care continuity was compared. Concurrent hospice care affected care continuity. It resulted in longer lengths of stays in hospice (β = 2.76, p < 0.001) and reduced hospice live discharges (β = −2.80, p < 0.05), compared to standard hospice care. Concurrent care was not effective at reducing emergency room (β = 2.09, p < 0.001) or inpatient care (β = 0.007, p < 0.05) transitions during hospice enrollment. Our study provides critical insight into the quality of care delivered for children at end of life. These findings have policy implications.
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影响因子：
4.7
作者：
Lindley, Lisa C.;Mack, Jennifer W.;Bruce, Donald J.
通讯作者：
Bruce, Donald J.
DOI：
10.1377/hlthaff.2020.01192
发表时间：
2020-10
期刊：
Health affairs (Project Hope)
影响因子：
--
作者：
Laird J;Cozad MJ;Keim-Malpass J;Mack JW;Lindley LC
通讯作者：
Lindley LC
DOI：
10.1097/cin.0000000000000677
发表时间：
2020-09
期刊：
Computers, informatics, nursing : CIN
影响因子：
--
作者：
Lindley LC;Svynarenko R;Profant TL
通讯作者：
Profant TL
影响因子：
2.6
作者：
Feudtner, Chris
通讯作者：
Feudtner, Chris
影响因子：
1.4
作者：
D'Angelo, Daniela;Mastroianni, Chiara;De Marinis, Maria Grazia
通讯作者：
De Marinis, Maria Grazia