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Does referral to specialist paediatric palliative care services reduce hospital admissions in oncology patients at the end of life?
- Source :
-
British journal of cancer [Br J Cancer] 2013 Apr 02; Vol. 108 (6), pp. 1273-9. Date of Electronic Publication: 2013 Feb 28. - Publication Year :
- 2013
-
Abstract
- Background: Despite advances in the treatment of childhood cancer, some children continue to die from their disease. This study aimed to assess the impact of specialist paediatric palliative care services (SPPCSs) on the number of hospital admissions in children who subsequently died from cancer in Yorkshire, UK.<br />Methods: An extract of patients aged 0-19 years from the Yorkshire Specialist Register of Cancer in Children and Young People (YSRCCYP) diagnosed from 1990 to 2009 were linked to inpatient hospital episodes data and a SPPCS database. Deaths were included if they occurred before 31 August 2011. Differences in hospital admission patterns were assessed using negative binomial regression and presented as incidence rate ratios (IRRs).<br />Results: Of 2508 children on the YSRCCYP, 657 (26%) had died by the censoring date. A total of 211 children had been referred to the local SPPCS, of whom 182 (86%) had subsequently died. Referral to SPPCS was associated with a significant reduction in the rate of planned hospital admissions (IRR=0.60, 95% CI 0.43-0.85). Central nervous system tumours showed significant decreases for all planned and emergency admissions compared with all other diagnostic groups.<br />Conclusion: Referral to SPPCS significantly reduced the number of planned hospital admissions for children and young people with cancer before their death, which are often integral to paediatric oncology treatment regimens. Overall, our findings show that SPPCS have a role in reducing hospital admissions during end of life care of paediatric cancer patients with potential personal, social and economic benefits.
- Subjects :
- Adolescent
Adult
Child
Child, Preschool
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Male
Prognosis
Young Adult
Hospitalization statistics & numerical data
Neoplasms therapy
Palliative Care
Patient Admission statistics & numerical data
Referral and Consultation
Specialization statistics & numerical data
Terminal Care
Subjects
Details
- Language :
- English
- ISSN :
- 1532-1827
- Volume :
- 108
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- British journal of cancer
- Publication Type :
- Academic Journal
- Accession number :
- 23449361
- Full Text :
- https://doi.org/10.1038/bjc.2013.89