Evidence map›Paper›PMID 35237837›Full record

ArticleSouthern medical journal2022

Comparison between Rural and Urban Appalachian Children in Hospice Care.

Mary Lou Clark Fornehed, Radion Svynarenko, Jessica Keim-Malpass, Melanie J Cozad, Kerri A Qualls, Whitney L Stone, Lisa C Lindley

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Southern medical journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Impact of Concurrent Hospice Care on Primary Care Visits Among Children in Rural Southern Appalachia.Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners
    Article
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

7 authors.

Mary Lou Clark FornehedFrom the Whitson-Hester School of Nursing, Tennessee Technological University, Cookeville, the College of Nursing, University of Tennessee, Knoxville, the School of Nursing, University of Virginia, Charlottesville, and the Department of Health Services Policy and Management, Center for Effectiveness Research in Orthopedics, University of South Carolina, Columbia.
Radion SvynarenkoFrom the Whitson-Hester School of Nursing, Tennessee Technological University, Cookeville, the College of Nursing, University of Tennessee, Knoxville, the School of Nursing, University of Virginia, Charlottesville, and the Department of Health Services Policy and Management, Center for Effectiveness Research in Orthopedics, University of South Carolina, Columbia.
Jessica Keim-MalpassFrom the Whitson-Hester School of Nursing, Tennessee Technological University, Cookeville, the College of Nursing, University of Tennessee, Knoxville, the School of Nursing, University of Virginia, Charlottesville, and the Department of Health Services Policy and Management, Center for Effectiveness Research in Orthopedics, University of South Carolina, Columbia.
Melanie J CozadFrom the Whitson-Hester School of Nursing, Tennessee Technological University, Cookeville, the College of Nursing, University of Tennessee, Knoxville, the School of Nursing, University of Virginia, Charlottesville, and the Department of Health Services Policy and Management, Center for Effectiveness Research in Orthopedics, University of South Carolina, Columbia.
Kerri A QuallsFrom the Whitson-Hester School of Nursing, Tennessee Technological University, Cookeville, the College of Nursing, University of Tennessee, Knoxville, the School of Nursing, University of Virginia, Charlottesville, and the Department of Health Services Policy and Management, Center for Effectiveness Research in Orthopedics, University of South Carolina, Columbia.
Whitney L StoneFrom the Whitson-Hester School of Nursing, Tennessee Technological University, Cookeville, the College of Nursing, University of Tennessee, Knoxville, the School of Nursing, University of Virginia, Charlottesville, and the Department of Health Services Policy and Management, Center for Effectiveness Research in Orthopedics, University of South Carolina, Columbia.
Lisa C LindleyFrom the Whitson-Hester School of Nursing, Tennessee Technological University, Cookeville, the College of Nursing, University of Tennessee, Knoxville, the School of Nursing, University of Virginia, Charlottesville, and the Department of Health Services Policy and Management, Center for Effectiveness Research in Orthopedics, University of South Carolina, Columbia.

Funding

The effectiveness of concurrent hospice care to improve pediatric and family outcomes at end of lifeR01NR017848 · NINR · UNIVERSITY OF TENNESSEE KNOXVILLE · PI Lisa C. Lindley · 2018 to 2026
$3.0M
Effectiveness of end-of-life strategies to improve pediatric health outcomes and reduce disparities in rural AppalachiaR56NR019444 · NINR · UNIVERSITY OF TENNESSEE KNOXVILLE · PI LINDLEY, LISA C. · 2020 to 2021
$572k
NINR NIH HHS R01 NR017848NINR NIH HHS R56 NR019444
6 · The paper itself

Abstract

objectiveThe goal of this study was to compare rural and urban pediatric hospice patients in Appalachia.

methodsUsing a retrospective, nonexperimental design, we sought to compare characteristics of Appalachian rural and urban children younger than 21 years enrolled in the Medicaid hospice benefit. Descriptive statistics were calculated on the demographic, hospice, and clinical characteristics of children from Appalachia. Comparisons were calculated using Pearson χ

resultsLess than half of the 1788 Appalachian children admitted to hospice care resided in rural areas (40%). Compared with children in urban areas of Appalachia, rural children were significantly younger (8 years vs 9.5 years) and more often had a complex chronic condition (56.0% vs 35.1%) and comorbidities (38.5% vs 17.0%) with technology dependence (32.6% vs 17.0%). Children in rural Appalachian were commonly from communities in the southern region of Appalachia (27.9% vs <10.0%), with median household incomes <$50,000/year (96.7% vs 22.4%). Significant differences were present in clinical care between rural and urban Appalachian children. Rural children had longer lengths of stay in hospice care (38 days vs 11 days) and were less likely to use the emergency department during hospice admission (19.0% vs 43.0%). These children more often visited their primary care provider (49.9% vs 31.3%) and sought care for symptoms from nonhospice providers (18.1% vs 10.0%) while admitted to hospice.

conclusionsOur results suggest that children admitted to hospice care in rural versus urban Appalachia have distinct characteristics. Rural children are admitted to hospice care with significant medical complexities and reside in areas of poverty. Hospice care for rural children suggests a continuity of care with longer hospice stays and fewer transitions to the emergency department; however, the potential for care fragmentation is present, with frequent visits to primary care and nonhospice providers for symptom management. Understanding the unique characteristics of children in Appalachia may be essential for advancing knowledge and care for these children at the end of life. Future research examining geographic variation in hospice care in Appalachia is warranted.

Indexed as

Hospice CareAppalachian RegionChildEmergency Service, HospitalHospitalizationHumansRetrospective StudiesUnited States

Identifiers

PMID35237837
PMCPMC8908896

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.