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Developing a Pediatric Palliative Care Program: Addressing the Lack of Baseline Expenditure Information

Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida, cak{at}ichp.ufl.edu

Lindsay A. Thompson, MD, MS

Department of Epidemiology and Health Policy Research, College of Medicine, University of Florida, Gainesville, Florida

W. Bruce Vogel, PhD

Department of Epidemiology and Health Policy Research, College of Medicine, University of Florida, Gainesville, Florida

Vanessa L. Madden, BSc

Department of Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, Florida

Elizabeth A. Shenkman, PhD

Department of Epidemiology and Health Policy Research, College of Medicine, University of Florida, Gainesville, Florida

An estimated 500 000 children annually cope with life-limiting conditions expected to lead to premature death, but little is known about their health care expenditures at the end of life. This information is crucial for health planners to propose pediatric palliative care programs. This study aims to estimate predicted health care expenditures for Medicaid-eligible infants and children across several health service categories. Across these categories, infants and children were predicted to spend about US$110 000 and US$62 000 at the end of life, respectively. About 5% of infants and 8% of children incurred hospice expenditures. Results from the multivariate models suggest that black, non-Hispanic children are less likely than white, non-Hispanic children to use hospice care. Baseline expenditure information from this study can be used to develop integrated pediatric palliative care models. Our findings also suggest that many more children could potentially benefit by using hospice care at the end of life.

Key Words: children • palliative care • Medicaid • expenditures • end of life

This version was published on February 1, 2009

American Journal of Hospice and Palliative Medicine®, Vol. 26, No. 1, 40-46 (2009)
DOI: 10.1177/1049909108327025


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