Evidence map›Paper›PMID 25844372›Full record

ArticleCMAJ open

Effect of pediatric palliative care programs on health care resource utilization and costs among children with life-threatening conditions: a systematic review of comparative studies.

Tania Conte, Craig Mitton, Logan M Trenaman, Negar Chavoshi, Harold Siden

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Impact of Specialized Pediatric Palliative Care: A Systematic Review.Journal of pain and symptom management · 2020
    Pooled it
  4. Trial
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  11. Pediatric palliative care in the medical neighborhood for children with medical complexity.Families, systems & health : the journal of collaborative family healthcare · 2019
    Article
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  17. Bending the Cost Curve in Childhood Cancer.Current hematologic malignancy reports · 2016
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Tania ConteSchool of Population and Public Health, University of British Columbia, Vancouver, BC ; Centre for Clinical Epidemiology and Evaluation, Vancouver, BC.
Craig MittonSchool of Population and Public Health, University of British Columbia, Vancouver, BC ; Centre for Clinical Epidemiology and Evaluation, Vancouver, BC.
Logan M TrenamanSchool of Population and Public Health, University of British Columbia, Vancouver, BC ; Centre for Clinical Epidemiology and Evaluation, Vancouver, BC.
Negar ChavoshiSchool of Population and Public Health, University of British Columbia, Vancouver, BC ; Canuck Place Children's Hospice, Vancouver, BC.
Harold SidenCanuck Place Children's Hospice, Vancouver, BC ; Child and Family Research Institute, Vancouver, BC ; Division of General Pediatrics, Department of Pediatrics, University of British Columbia, Vancouver, BC.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPediatric palliative care is a relatively new and evolving field, and the cost of pediatric palliative care programs is unclear. We conducted a systematic review to compare inpatient health care utilization and costs among children with life-threatening conditions who have accessed a pediatric palliative care program and those who have not.

methodsWe searched MEDLINE, Embase, CINAHL and LILACS databases from January 2000 to July 2013, as well as the grey literature, for experimental or observational studies that compared pediatric palliative care programs with usual care. Outcomes of interest included hospital admissions, length of stay and health care costs.

resultsOf the 5193 records identified, we reviewed 109 in full and included 11 in our study. The overall quality of the studies was moderate to low. We observed mixed results for all outcomes. Compared with patients receiving usual care, fewer patients in the palliative care group had hospital admissions and fewer of those with cancer had planned hospital admissions. In contrast, no effects were observed regarding the overall number of hospital, emergency or outpatient admissions. Conflicting results were observed with regards to critical care utilization. Studies showed a trend toward shorter lengths of stay in hospital in the palliative care group. However, a single study that also considered inpatient time in hospice facilities found an increase in total length of stay, which showed a shift in the setting of health care utilization. We observed no conclusive trend in the effects on cost.

interpretationEvidence suggests that pediatric palliative care programs may result in a shift of utilization to other health care settings beyond hospital care. These settings should be considered when measuring resource utilization and costs.

Identifiers

PMID25844372
PMCPMC4382033

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.