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Cost disparities exist among pediatric palliative care patients

The cost of inpatient pediatric palliative care was lower among patients who were near death compared with survivors, according to a recently published study in Pediatrics.

“Our findings suggest that among children who have experienced substantial previous inpatient care, health care which emphasizes quality of life does not increase cost and may cost less when children are close to death,” Andrew G. Smith, MD, department of pediatrics at the University of Utah School of Medicine, and colleagues wrote. “These mixed findings are likely due to the various reasons why high-cost inpatients were referred to and received [pediatric palliative care].”

The researchers performed a retrospective study of high-cost inpatients (n = 86) who received pediatric palliative care (PPC) at Primary Children’s Hospital in 2010 to assess the association between cost and care. After a 2-year follow-up, patients were grouped into three categories: patients who died during or near their terminal hospitalization; patients who died during follow-up; and patients who survived follow-up.

Patients receiving PPC were associated with older age, technology dependence, multiple chronic conditions, PICU admissions and death in 2010. Compared with patients not receiving PPC, PPC recipients had increased inpatient costs (median: $138,168 vs. $90,791).

Results demonstrated that patients who received PPC and died during the 2-year follow up had significantly lower inpatient costs vs. patients who survived the follow-up. No significant differences in inpatient costs, however, were found when factoring for patient complexities.

“Because PPC cares for patients both near and far from death, a better description of pediatrics patients who receive PPC is not simply that they have a high risk of death but also that they will likely always have significant medical needs due to their serious underlying conditions and thus are likely to be lifelong high-resource utilizers,” Smith and colleagues said. – by Casey Hower

Disclosure: The researchers report no relevant financial disclosures.