An Examination of Hospice Use Among Children

描述（由申请人提供）：本K 01指导研究科学家发展奖的目的是准备丽莎C。林德利，博士，注册护士为一个独立的卫生服务和政策研究的职业生涯，特别关注儿科临终关怀。职业发展计划包括三个目标，以实现候选人的职业目标，包括：1）在儿科临终关怀中建立临床和政策基础; 2）获得先进的研究方法和统计知识; 3）扩大研究沟通能力。发展计划将包括精心挑选的课程和活动的指导下，一个专家导师和咨询团队，包括博士Shih-Lung肖，莫林里昂，詹妮弗麦克，保罗欧文，和唐布鲁斯。该计划还将包括进行一项研究，审查儿童使用临终关怀的情况，这将导致未来的R系列赠款申请。本研究旨在了解儿童的特征如何影响临终关怀服务的利用。本研究将采用一种创新的地理信息系统方法，沿着纵向管理数据，采用回顾性队列设计，以解决以下具体目标：1）通过描述儿童临终关怀使用的地理分布，探索儿童临终关怀使用的地理模式，确定儿童临终关怀使用的地理集群，并比较儿童临终关怀使用和不使用的地理集群;以及2）检查儿童特征的影响（即，地理，人口，健康）对儿科临终关怀的使用，同时控制社区特征。预计该研究的结果将为临床和政策倡议提供关于如何改善儿科临终关怀的信息。

DESCRIPTION (provided by applicant): The purpose of this K01 Mentored Research Scientist Development Award is to prepare Lisa C. Lindley, PhD, RN for an independent health services and policy research career with a special focus on pediatric end-of-life care. The career development plan entails three objectives to achieve the career goals of the candidate that include: 1) developing a clinical and policy grounding in pediatric end-of-life care; 2) acquiring knowledge of advanced research methods and statistics; and 3) expanding research communication abilities. The development plan will consist of thoughtfully selected coursework and activities under the guidance of an expert mentorship and advisory team including Drs. Shih-Lung Shaw, Maureen Lyon, Jennifer Mack, Paul Erwin, and Don Bruce. The plan will also include conducting a study to examine hospice use among children that will lead to future R-series grant applications. The research project seeks to understand how the characteristics of children influence utilization of hospice care services. Using an innovative geographic information systems approach along with longitudinal administrative data, this study will employ a retrospective cohort design to address the following specific aims: 1) to explore geographic patterns of hospice use among children by describing the geographic distribution of pediatric hospice use, identify geographic clusters of pediatric hospice use, and compare geographic clusters of pediatric hospice use and nonuse; and 2) to examine the effects of child characteristics (i.e., geographic, demographic, health) on pediatric hospice use while controlling for community characteristics. It is anticipated that the results of the study will inform clinicaland policy initiatives on how to improve access to pediatric hospice care.