title: Pediatric palliative care programs in children's hospitals: a cross-sectional national survey.
abstract: BACKGROUND
  Pediatric palliative care (PPC) programs facilitate the provision of comprehensive care to seriously ill children. Over the past 10 years many such programs have been initiated by children's hospitals, but little is known about their number, staff composition, services offered, sources of support, or national distribution.
  
  
  METHODS
  In the summer of 2012, we surveyed 226 hospitals as identified by the National Association of Children's Hospitals and Related Institutions. The survey instrument gathered data about whether their institution had a PPC program, and for hospitals with programs, it asked for a wide range of information including staffing, patient age range, services provided, and financial support.
  
  
  RESULTS
  Of the 162 hospitals that provided data (71.7% response rate), 69% reported having a PPC program. The rate of new program creation peaked in 2008, with 12 new programs created that year, and 10 new programs in 2011. Most programs offer only inpatient services, and most only during the work week. The number of consults per year varied substantially across programs, and was positively associated with hospital bed size and number of funded staff members. PPC programs report a high level of dependence on hospital funding.
  
  
  CONCLUSIONS
  PPC programs are becoming common in children's hospitals throughout the United States yet with marked variation in how these programs are staffed, the level of funding for staff effort to provide PPC, and the number of consultations performed annually. Guidelines for PPC team composition, funding, and consultation standards may be warranted to ensure the highest quality of PPC.
authors.affiliation: CHOP North, Room 1523, The Children's Hospital of Philadelphia, 34th and Civic Center Blvd, Philadelphia, PA 10194. feudtner@email.chop.edu.
authors.forename: Chris
authors.initials: C
authors.lastname: Feudtner
authors.forename: James
authors.initials: J
authors.lastname: Womer
authors.forename: Rachel
authors.initials: R
authors.lastname: Augustin
authors.forename: Stacy
authors.initials: S
authors.lastname: Remke
authors.forename: Joanne
authors.initials: J
authors.lastname: Wolfe
authors.forename: Sarah
authors.initials: S
authors.lastname: Friebert
authors.forename: David
authors.initials: D
authors.lastname: Weissman
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D019538:Health Care Surveys; D061889:Healthcare Financing; D006776:Hospitals, Pediatric / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010166:Palliative Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States
keywords: hospice care; hospital care; palliative care; pediatric; survey