title: Developing a pediatric palliative care program: addressing the lack of baseline expenditure information.
abstract: An estimated 500 000 children annually cope with life-limiting conditions expected to lead to premature death, but little is known about their health care expenditures at the end of life. This information is crucial for health planners to propose pediatric palliative care programs. This study aims to estimate predicted health care expenditures for Medicaid-eligible infants and children across several health service categories. Across these categories, infants and children were predicted to spend about US$110 000 and US$62 000 at the end of life, respectively. About 5% of infants and 8% of children incurred hospice expenditures. Results from the multivariate models suggest that black, non-Hispanic children are less likely than white, non-Hispanic children to use hospice care. Baseline expenditure information from this study can be used to develop integrated pediatric palliative care models. Our findings also suggest that many more children could potentially benefit by using hospice care at the end of life.
authors.affiliation: Department of Pediatrics, College of Medicine, University of Florida, 1329 SW 16th Street, Gainesville, FL 32608, USA. cak@ichp.ufl.edu
authors.forename: Caprice A
authors.initials: CA
authors.lastname: Knapp
authors.forename: Lindsay A
authors.initials: LA
authors.lastname: Thompson
authors.forename: W Bruce
authors.initials: WB
authors.lastname: Vogel
authors.forename: Vanessa L
authors.initials: VL
authors.lastname: Madden
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Shenkman
mesh_terms: D002648:Child; D002669:Child Welfare / Q000191:economics* / Q000706:statistics & numerical data; D002675:Child, Preschool; D016638:Critical Illness / Q000191:economics*; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006302:Health Services Research; D017051:Hospice Care / Q000191:economics* / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008484:Medicaid / Q000191:economics; D010166:Palliative Care / Q000191:economics* / Q000458:organization & administration / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D016730:Program Development; D014481:United States / Q000453:epidemiology