An Examination of Hospice Use Among Children

描述(由申请人提供)：K01指导研究科学家发展奖的目的是为Lisa C.Lindley博士和RN为独立的医疗服务和政策研究职业生涯做准备，特别关注儿科临终关怀。职业发展计划需要三个目标来实现候选人的职业目标，其中包括：1)建立以儿科临终关怀为基础的临床和政策基础；2)获得先进研究方法和统计的知识；3)扩大研究沟通能力。发展计划将包括经过深思熟虑选择的课程和活动，在专家指导和咨询团队的指导下进行，顾问团队包括邵世龙博士、Maureen Lyon博士、Jennifer Mack、Paul Erwin和Don Bruce博士。该计划还将包括进行一项研究，以检查儿童对临终关怀的使用情况，这将导致未来的R系列拨款申请。该研究项目试图了解儿童的特征如何影响临终关怀服务的利用。使用创新的地理信息系统方法和纵向管理数据，本研究将采用回溯性队列设计来解决以下具体目标：1)通过描述儿科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，确定儿科临终关怀使用的地理集群，并比较儿科临终关怀使用和不使用的地理集群；以及2)在控制社区特征的同时，检查儿童特征(即地理、人口、健康)对儿科临终关怀使用的影响。预计这项研究的结果将为临床和政策倡议如何改善获得儿童临终关怀提供信息。

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.