Please use this identifier to cite or link to this item: https://doi.org/10.1186/s12904-017-0267-z
Title: Paediatric palliative care improves patient outcomes and reduces healthcare costs: Evaluation of a home-based program
Authors: Chong, P.H 
De Castro Molina, J.A
Teo, K
Tan, W.S
Keywords: adult
advance care planning
Article
caregiver burden
cohort analysis
controlled study
cystic fibrosis
Duchenne muscular dystrophy
economic aspect
ethnicity
female
health care cost
health care policy
health care utilization
hospice care
hospitalization
human
length of stay
major clinical study
male
palliative therapy
pediatric advanced life support
pediatric palliative care
prematurity
prospective study
quality of life
retrospective study
terminal care
adolescent
child
health care cost
home care
infant
organization and management
outcome assessment
palliative therapy
pediatrics
preschool child
psychology
Singapore
standards
statistics and numerical data
Adolescent
Child
Child, Preschool
Cohort Studies
Female
Health Care Costs
Home Care Services
Humans
Infant
Male
Palliative Care
Patient Outcome Assessment
Pediatrics
Prospective Studies
Quality of Life
Retrospective Studies
Singapore
Issue Date: 2018
Citation: Chong, P.H, De Castro Molina, J.A, Teo, K, Tan, W.S (2018). Paediatric palliative care improves patient outcomes and reduces healthcare costs: Evaluation of a home-based program. BMC Palliative Care 17 (1) : 11. ScholarBank@NUS Repository. https://doi.org/10.1186/s12904-017-0267-z
Rights: Attribution 4.0 International
Abstract: Background Around the world, different models of paediatric palliative care have responded to the unique needs of children with life shortening conditions. However, research confirming their utility and impact is still lacking. This study compared patient-related outcomes and healthcare expenditures between those who received home-based paediatric palliative care and standard care. The quality of life and caregiver burden for patients receiving home-based paediatric palliative care were also tracked over the first year of enrolment to evaluate the service's longitudinal impact. Method A structured impact and cost evaluation of Singapore-based HCA Hospice Care's Star PALS (Paediatric Advance Life Support) programme was conducted over a three-year period, employing both retrospective and prospective designs with two patient groups. Results Compared to the control group (n = 67), patients receiving home-based paediatric palliative care (n = 71) spent more time at home than in hospital in the last year of life by 52 days (OR = 52.30, 95% CI: 25.44-79.17) with at least two fewer hospital admissions (OR = 2.46, 95% CI: 0.43-4.48); and were five times more likely to have an advance care plan formulated (OR = 5.51, 95% CI: 1.55-19.67). Medical costs incurred by this group were also considerably lower (by up to 87%). Moreover, both patients' quality of life (in terms of pain and emotion), and caregiver burden showed improvement within the first year of enrolment into the programme. Discussion Our findings suggest that home-based paediatric palliative care brings improved resource utilization and cost-savings for both patients and healthcare providers. More importantly, the lives of patients and their caregivers have improved, with terminally ill children and their caregivers being able to spend more quality time at home at the final stretch of the disease. Conclusions The benefits of a community paediatric palliative care programme have been validated. Study findings can become key drivers when engaging service commissioners or even policy makers in appropriate settings. © 2018, The Author(s).
Source Title: BMC Palliative Care
URI: https://scholarbank.nus.edu.sg/handle/10635/181228
ISSN: 1472684X
DOI: 10.1186/s12904-017-0267-z
Rights: Attribution 4.0 International
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