医疗复杂性与并发临终关怀:2011 - 2013年医疗补助儿童的全国研究

IF 1.2 4区 医学 Q3 NURSING Journal for Specialists in Pediatric Nursing Pub Date : 2021-04-03 DOI:10.1111/jspn.12333
Jessica Keim-Malpass PhD, RN, Melanie J. Cozad PhD, Radion Svynarenko PhD, Jennifer W. Mack MD, MPH, Lisa C. Lindley PhD, RN, FPCN, FAAN
{"title":"医疗复杂性与并发临终关怀:2011 - 2013年医疗补助儿童的全国研究","authors":"Jessica Keim-Malpass PhD, RN,&nbsp;Melanie J. Cozad PhD,&nbsp;Radion Svynarenko PhD,&nbsp;Jennifer W. Mack MD, MPH,&nbsp;Lisa C. Lindley PhD, RN, FPCN, FAAN","doi":"10.1111/jspn.12333","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>Pediatric hospice is a comprehensive model of care for medically complex children at end of life. The Affordable Care Act changed regulatory requirements for pediatric Medicaid enrollees to allow for enrollment into hospice services while still receiving life-prolonging therapy. There are gaps in understanding factors associated with pediatric concurrent hospice care use. The objectives were to examine the prevalence of concurrent hospice care overtime and investigated the relationship between medical complexity and concurrent hospice care among Medicaid children.</p>\n </section>\n \n <section>\n \n <h3> Design and Methods</h3>\n \n <p>We used national Medicaid data and included children less than 21 years with an admission to hospice care. Medical complexity was defined with four criteria (i.e., chronic conditions, functional limitations, high health care use and substantial needs). Using multivariate logistic regression, we evaluated the influence of medical complexity on concurrent hospice care use, while controlling for demographic, hospice, and community characteristics.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Thirty-four percent of the study sample used concurrent hospice care. Medical complexity was unrelated to concurrent hospice care. However, the four individual criteria were associated. A complex chronic condition was negatively related to concurrent hospice care, whereas technology dependence, multiple complex chronic conditions, and mental/behavioral disorders were positively associated to concurrent care use.</p>\n </section>\n \n <section>\n \n <h3> Practice Implications</h3>\n \n <p>These findings suggest that concurrent hospice care may be important for a subset of medically complex children with functional limitations, high health utilization, and substantial needs at end of life.</p>\n </section>\n </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2021-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12333","citationCount":"12","resultStr":"{\"title\":\"Medical complexity and concurrent hospice care: A national study of Medicaid children from 2011 to 2013\",\"authors\":\"Jessica Keim-Malpass PhD, RN,&nbsp;Melanie J. Cozad PhD,&nbsp;Radion Svynarenko PhD,&nbsp;Jennifer W. Mack MD, MPH,&nbsp;Lisa C. Lindley PhD, RN, FPCN, FAAN\",\"doi\":\"10.1111/jspn.12333\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Purpose</h3>\\n \\n <p>Pediatric hospice is a comprehensive model of care for medically complex children at end of life. The Affordable Care Act changed regulatory requirements for pediatric Medicaid enrollees to allow for enrollment into hospice services while still receiving life-prolonging therapy. There are gaps in understanding factors associated with pediatric concurrent hospice care use. The objectives were to examine the prevalence of concurrent hospice care overtime and investigated the relationship between medical complexity and concurrent hospice care among Medicaid children.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Design and Methods</h3>\\n \\n <p>We used national Medicaid data and included children less than 21 years with an admission to hospice care. Medical complexity was defined with four criteria (i.e., chronic conditions, functional limitations, high health care use and substantial needs). Using multivariate logistic regression, we evaluated the influence of medical complexity on concurrent hospice care use, while controlling for demographic, hospice, and community characteristics.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Thirty-four percent of the study sample used concurrent hospice care. Medical complexity was unrelated to concurrent hospice care. However, the four individual criteria were associated. A complex chronic condition was negatively related to concurrent hospice care, whereas technology dependence, multiple complex chronic conditions, and mental/behavioral disorders were positively associated to concurrent care use.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Practice Implications</h3>\\n \\n <p>These findings suggest that concurrent hospice care may be important for a subset of medically complex children with functional limitations, high health utilization, and substantial needs at end of life.</p>\\n </section>\\n </div>\",\"PeriodicalId\":54900,\"journal\":{\"name\":\"Journal for Specialists in Pediatric Nursing\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2021-04-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1111/jspn.12333\",\"citationCount\":\"12\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal for Specialists in Pediatric Nursing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jspn.12333\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal for Specialists in Pediatric Nursing","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jspn.12333","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 12

摘要

目的儿童安宁疗护是一种针对医学上复杂的生命末期儿童的综合疗护模式。《平价医疗法案》改变了对儿科医疗补助计划参保人的监管要求,允许他们在接受延长生命治疗的同时加入临终关怀服务。在了解与儿童同时安宁疗护使用相关的因素方面存在差距。本研究的目的是探讨医疗补助儿童加班同时接受安宁疗护的现况,并探讨医疗复杂度与同时接受安宁疗护的关系。设计与方法我们使用国家医疗补助数据,纳入入院接受临终关怀的21岁以下儿童。医疗复杂性的定义有四个标准(即慢性病、功能限制、高保健使用率和大量需求)。在控制人口统计学、安宁疗护和社区特征的情况下,我们使用多元逻辑回归评估医疗复杂性对同时安宁疗护使用的影响。结果34%的研究样本同时接受安宁疗护。医疗复杂性与并发临终关怀无关。然而,这四个单独的标准是相互关联的。复杂慢性疾病与同时接受安宁疗护有负相关,而技术依赖、多重复杂慢性疾病及精神/行为障碍与同时接受安宁疗护有正相关。实践启示这些研究结果提示,对于部分功能受限、健康利用率高、临终时有实质需求的医学复杂儿童,同时进行安宁疗护可能是重要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

摘要图片

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Medical complexity and concurrent hospice care: A national study of Medicaid children from 2011 to 2013

Purpose

Pediatric hospice is a comprehensive model of care for medically complex children at end of life. The Affordable Care Act changed regulatory requirements for pediatric Medicaid enrollees to allow for enrollment into hospice services while still receiving life-prolonging therapy. There are gaps in understanding factors associated with pediatric concurrent hospice care use. The objectives were to examine the prevalence of concurrent hospice care overtime and investigated the relationship between medical complexity and concurrent hospice care among Medicaid children.

Design and Methods

We used national Medicaid data and included children less than 21 years with an admission to hospice care. Medical complexity was defined with four criteria (i.e., chronic conditions, functional limitations, high health care use and substantial needs). Using multivariate logistic regression, we evaluated the influence of medical complexity on concurrent hospice care use, while controlling for demographic, hospice, and community characteristics.

Results

Thirty-four percent of the study sample used concurrent hospice care. Medical complexity was unrelated to concurrent hospice care. However, the four individual criteria were associated. A complex chronic condition was negatively related to concurrent hospice care, whereas technology dependence, multiple complex chronic conditions, and mental/behavioral disorders were positively associated to concurrent care use.

Practice Implications

These findings suggest that concurrent hospice care may be important for a subset of medically complex children with functional limitations, high health utilization, and substantial needs at end of life.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
2.50
自引率
7.70%
发文量
27
审稿时长
>12 weeks
期刊介绍: Linking science and practice by publishing evidence-based information on pediatric nursing and answering the question, ''How might this information affect nursing practice?'' The Journal for Specialists in Pediatric Nursing (JSPN) is the international evidence-based practice journal for nurses who specialize in the care of children and families. JSPN bridges the gap between research and practice by publishing peer-reviewed reliable, clinically relevant, and readily applicable evidence. The journal integrates the best evidence with pediatric nurses'' passion for achieving the best outcomes. The journal values interdisciplinary perspectives and publishes a wide variety of peer-reviewed papers on clinically relevant topics.
期刊最新文献
Issue Information Identifying actions taken by health care professionals during procedures involving children with autism spectrum disorders in a high technological environment: Using critical incident technique Factors influencing job stress in pediatric nurses during the pandemic period: Focusing on fatigue, pediatric nurse−parent partnership Issue Information Sexuality education for school-aged children and adolescents: A concept analysis
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1