Pediatric palliative care and inpatient hospital costs: A longitudinal cohort study

Andrew G. Smith, Seth Andrews, Susan L. Bratton, Joan Sheetz, Chris Feudtner, Wenjun Zhong, Christopher G. Maloney

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

BACKGROUND: Pediatric palliative care (PPC) improves the quality of life for children with life-limiting conditions, but the cost of care associated with PPC has not been quantified. This study examined the association between inpatient cost and receipt of PPC among high-cost inpatients. METHODS: The 10% most costly inpatients treated at a children's hospital in 2010 were studied, and factors associated with receipt of PPC were determined. Among patients dying during 2010, we compared 2010 inpatient costs between PPC recipients and nonrecipients. Inpatient costs during the 2-year follow up period between PPC recipients and nonrecipients were also compared. Patients were analyzed in 2 groups: those who died and those who survived the 2-year follow-up. RESULTS: Of 902 patients, 86 (10%) received PPC. Technology dependence, older age, multiple chronic conditions, PICU admission, and death in 2010 were independently associated with receipt of PPC. PPC recipients had increased inpatient costs compared with nonrecipients during 2010. Among patients who died during the 2-year follow-up, PPC recipients had significantly lower inpatient costs. Among survivors, PPC recipients had greater inpatient costs. When controlling for patient complexity, differences in inpatient costs were not significant. CONCLUSIONS: The relationship of PPC to inpatient costs is complex. PPC seems to lower costs among patients approaching death. Patients selectively referred to PPC who survive most often do so with chronic serious illnesses that predispose them to remain lifelong highresource utilizers.

Original languageEnglish (US)
Pages (from-to)694-700
Number of pages7
JournalPediatrics
Volume135
Issue number4
DOIs
StatePublished - Apr 1 2015

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Hospital Costs
Palliative Care
Longitudinal Studies
Inpatients
Cohort Studies
Pediatrics
Costs and Cost Analysis
Survivors

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Smith, A. G., Andrews, S., Bratton, S. L., Sheetz, J., Feudtner, C., Zhong, W., & Maloney, C. G. (2015). Pediatric palliative care and inpatient hospital costs: A longitudinal cohort study. Pediatrics, 135(4), 694-700. https://doi.org/10.1542/peds.2014-3161

Pediatric palliative care and inpatient hospital costs : A longitudinal cohort study. / Smith, Andrew G.; Andrews, Seth; Bratton, Susan L.; Sheetz, Joan; Feudtner, Chris; Zhong, Wenjun; Maloney, Christopher G.

In: Pediatrics, Vol. 135, No. 4, 01.04.2015, p. 694-700.

Research output: Contribution to journalArticle

Smith, AG, Andrews, S, Bratton, SL, Sheetz, J, Feudtner, C, Zhong, W & Maloney, CG 2015, 'Pediatric palliative care and inpatient hospital costs: A longitudinal cohort study', Pediatrics, vol. 135, no. 4, pp. 694-700. https://doi.org/10.1542/peds.2014-3161
Smith AG, Andrews S, Bratton SL, Sheetz J, Feudtner C, Zhong W et al. Pediatric palliative care and inpatient hospital costs: A longitudinal cohort study. Pediatrics. 2015 Apr 1;135(4):694-700. https://doi.org/10.1542/peds.2014-3161
Smith, Andrew G. ; Andrews, Seth ; Bratton, Susan L. ; Sheetz, Joan ; Feudtner, Chris ; Zhong, Wenjun ; Maloney, Christopher G. / Pediatric palliative care and inpatient hospital costs : A longitudinal cohort study. In: Pediatrics. 2015 ; Vol. 135, No. 4. pp. 694-700.
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