Geographic Variation in California Pediatric Hospice Care for Children and Adolescents: 2007-2010
Geographic Variation in California Pediatric Hospice Care for Children and Adolescents: 2007-2010
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DOI：
10.1177/1049909116678380
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发表时间：
2018-01-01
影响因子：
1.9
通讯作者：
Edwards, Sheri L.
中科院分区：
文献类型：
--
作者：
Lindley, Lisa C.;Edwards, Sheri L.
目的：绘制和描述加州儿童临终关怀需求与供给的地理分布，历时4年（2007-2010年）。方法：采用多个数据库进行描述性纵向研究。样本包括2036名儿童和青少年死者和136名儿科临终关怀提供者。地理编码的数据被用来创建本研究感兴趣的主要变量，儿童临终关怀的需求和供应。地理信息系统被用来制作热图以供分析。结果：近90%的儿童及青少年有安宁疗护的潜在需求，而超过10%的儿童及青少年有已实现的需求。洛杉矶周边地区的潜在需求密度最高。洛杉矶和圣地亚哥大都会社区周围的地区有最高密度的实现临终关怀需求。敏感性分析揭示了洛杉矶地区潜在需求和已实现需求的社区水平差异。超过30个儿科临终关怀提供者为洛杉矶和圣地亚哥地区提供护理。结论：洛杉矶地区潜在和已实现需求密度高，圣地亚哥地区已实现需求密度高，具有明显的潜在和已实现需求的地理格局。儿童临终关怀的供应基本上符合儿童和青少年的需要。未来的研究应继续探索儿童和青少年在生命末期的需求，特别是在大城市地区。
Objective: To map and describe the geographic distribution of pediatric hospice care need versus supply in California over a 4-year time period (2007-2010).Methods: Multiple databases were used for this descriptive longitudinal study. The sample consisted of 2036 children and adolescent decedents and 136 pediatric hospice providers. Geocoded data were used to create the primary variables of interest for this studyneed and supply of pediatric hospice care. Geographic information systems were used to create heat maps for analysis.Results: Almost 90% of the children and adolescents had a potential need for hospice care, whereas more than 10% had a realized need. The highest density of potential need was found in the areas surrounding Los Angeles. The areas surrounding the metropolitan communities of Los Angeles and San Diego had the highest density of realized hospice care need. Sensitivity analysis revealed neighborhood-level differences in potential and realized need in the Los Angeles area. Over 30 pediatric hospice providers supplied care to the Los Angeles and San Diego areas.Conclusion: There were distinctive geographic patterns of potential and realized need with high density of potential and realized need in Los Angeles and high density of realized need in the San Diego area. The supply of pediatric hospice care generally matched the needs of children and adolescents. Future research should continue to explore the needs of children and adolescents at end of life at the neighborhood level, especially in large metropolitan areas.