ArticlePediatrics2015
Hospital Use in the Last Year of Life for Children With Life-Threatening Complex Chronic Conditions.
Article in Pediatrics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 4 of them syntheses that pooled it.
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Who cites it
40 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Economic costs of health and social care for a child with a life-limiting condition in their last year of life: a systematic review.BMJ paediatrics open · 2025Pooled it
- How are children with medical complexity being identified in epidemiological studies? A systematic review.World journal of pediatrics : WJP · 2023Pooled it
- Predictors for place of death among children:A systematic review and meta-analyses of recent literature.European journal of pediatrics · 2020Pooled it
- Pooled it
- Complex Care Hospital Use and Postdischarge Coaching: A Randomized Controlled Trial.Pediatrics · 2018Trial
- ICD-10-based screening increased detection of hospitalisations potentially eligible for paediatric palliative care consultation in the emergency department: a validation study.BMC palliative care · 2026Article
- Parents' experiences of paediatric end-of-life care in the UK: a multisite qualitative study.BMJ supportive & palliative care · 2025Article
- Parents' experiences of the financial and employment impacts of their child receiving end-of-life care: a national qualitative study.BMC palliative care · 2025Article
- Healthcare professionals' perspectives of providing end-of-life care for infants, children and young people in acute settings: A multi-site qualitative study.Palliative medicine · 2025Article
- The role of 'familiarity' and 'normality' in supporting transition to end of life care in paediatric oncology: A qualitative study.Journal of advanced nursing · 2025Article
- "Death Is Not a Dirty Word:" A Qualitative Study of Emergency Clinician End-of-Life Communication.Pediatrics · 2024Article
- Harnessing Natural Language Processing to Assess Quality of End-of-Life Care for Children With Cancer.JCO clinical cancer informatics · 2024Article
- Intensity of end-of-life care among children with life-threatening conditions: a national population-based observational study.BMC pediatrics · 2023Observational
- Crossroads of parental decision making: Intersections of hope, communication, relationships, and emotions.Journal of child health care : for professionals working with children in the hospital and community · 2023Article
- Parent Priorities in End-of-Life Care for Children With Cancer.JAMA network open · 2023Article
- "More life and more days"-patient and care characteristics in a specialized acute pediatric palliative care inpatient unit.European journal of pediatrics · 2023Article
- Article
- End-of-life care quality for children with cancer who receive palliative care.Pediatric blood & cancer · 2022Article
- Mortality During Readmission Among Children in United States Children's Hospitals.The Journal of pediatrics · 2022Article
- Numbers, characteristics, and medical complexity of children with life-limiting conditions reaching age of transition to adult care in England: a repeated cross-sectional study [version 1; peer review: 2 approved].NIHR open research · 2022Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
BACKGROUND AND
objectivesAlthough many adults experience resource-intensive and costly health care in the last year of life, less is known about these health care experiences in children with life-threatening complex chronic conditions (LT-CCCs). We assessed hospital resource use in children by type and number of LT-CCCs.
methodsA retrospective analysis of 1252 children with LT-CCCs, ages 1 to 18 years, who died in 2012 within 40 US children's hospitals of the Pediatric Health Information System database. LT-CCCs were identified with International Classification of Diseases, 9th Revision, Clinical Modification codes. Using generalized linear models, we assessed hospital admissions, days, costs, and interventions (mechanical ventilation and surgeries) in the last year of life by type and number of LT-CCCs.
resultsIn the last year of life, children with LT-CCCs experienced a median of 2 admissions (interquartile range [IQR] 1-5), 27 hospital days (IQR 7-84), and $142 562 (IQR $45 270-$410 087) in hospital costs. During the terminal admission, 76% (n = 946) were mechanically ventilated; 36% (n = 453) underwent surgery. Hospital use was greatest (P < .001) among children with hematologic/immunologic conditions (99 hospital days [IQR 51-146]; cost = $504 145 [IQR $250 147-$879 331]) and children with ≥3 LT-CCCs (75 hospital days [IQR 28-132]; cost = $341 222 [IQR $146 698-$686 585]).
conclusionsHospital use for children with LT-CCCs in the last year of life varies significantly across the type and number of conditions. Children with hematologic/immunologic or multiple conditions have the greatest hospital use. This information may be useful for clinicians striving to improve care for children with LT-CCCs nearing the end of life.
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