A recent study found that access to pediatric palliative care is lacking despite the benefits it provides.
Pediatric palliative care (PPC) is underutilized for children and families in US hospitals, according to a recent study.
PPC is used to provide children with life-threatening illnesses with specialized care, improving their quality of life. Since its formation, PCP has been recognized as a subspecialty of medicine, but has still not been properly implemented in children’s hospitals.
Presence and function of PPCs have mostly been self-reported. Given a proper overview, PPCs can be empowered to improve resources and access. To analyze the presence of PPCs, investigators conducted a study that collected public data from the Children’s Hospital Association (CHA).
CHA conducted a survey across 231 hospitals in the United States about programs and services offered in 2020. Questions were formulated to create binary responses, such as whether a specific program was available at the hospital surveyed. Study results were aggregated and blinded.
Along with gathering demographic data about hospitals, the research team created 4 domains: operational, mission, educational, and financial. The operational domain included characteristics such as trauma level, long-term care facility, and home health. The missional domain included characteristics such as accreditation status, family advisory council, and family resource center.
Accreditation Council for Graduate Medical Education Residency program or American Medical Association affiliation were educational characteristics, while Accountable Care Organization (ACO) participation and designation as a federally qualified health center were economic characteristics. Data were summarized and analyzed using PC SAS version 9.4.
Of the 231 hospitals that received survey requests, 148 submitted information for fiscal year 2020. A PPC was reported in 119 of these, with 8 of 50 states presenting 5 or more PPC programs. PPC programs were more often seen in Midwest regions, followed by Northeast regions, then Southern regions, and finally Western regions. These changes were not significant enough for geographic location to be considered a factor on PPC prevalence.
PPC programs were more likely to be seen in freestanding children’s hospitals compared to pediatric settings in adult hospitals. The median number of staffed beds in settings with PPC programs was 185 compared with a median of 49 staffed beds in settings without PPC programs.
Access to hospice services, which is correlated with PPC presence, was reported in less than half of the facilities surveyed. PPC also correlated with NICU designation, home health services, magnet recognition, family advisory councils, social determinants of health, and family resource centers. PPC access was also associated with ACO designation.
The survey found that 1 in 5 hospitals lack access to PPC programs. Although access to PPC was listed as a key criterion for hospital quality by US News and World Report in 2006, access is still limited. Investigators concluded that expanding PPC access is an urgent priority.
Weaver MS, Shostrom VK, Kaye EC, Keegan A, Lindley LC. Palliative care programs in children’s hospitals. Pediatrics. 2022;150(4). doi:10.1542/peds.2022-057872
