An Age Group Comparison of Concurrent Hospice Care

被引:0
|
作者
Svynarenko, Radion [1 ]
Cozad, Melanie J. [2 ]
Lindley, Lisa C. [1 ]
机构
[1] Univ Tennessee, Coll Nursing, 1412 Circle Dr, Knoxville, TN 37996 USA
[2] Univ Nebraska Med Ctr, Dept Hlth Serv Res & Adm, Omaha, NE USA
关键词
Affordable Care Act; concurrent hospice care; cost-effectiveness; Medicaid; pediatric hospice care; HEALTH;
D O I
10.1097/NJH.0000000000001037
中图分类号
R47 [护理学];
学科分类号
1011 ;
摘要
This study aimed to examine the cost-effectiveness of concurrent hospice care compared with standard care among pediatric patients of different age groups. Using a national Medicaid database of 18 152 pediatric patients enrolled in hospice care between 2011 and 2013, this study calculated and analyzed incremental cost-effectiveness ratios (ICERs) for concurrent care versus standard hospice care for children of 4 age categories: <1 year, 1 to 5 years, 6 to 14 years, and 15 to 20 years. The results indicated that the total Medicaid cost of hospice care was $3229 per patient per month (PPPM; SD, $8709) for those younger than 1 year, $4793 PPPM (SD, $8178) for those aged 1 to 5 years, $5411 PPPM (SD, $7456) for those aged 6 to 14 years, and $5625 PPPM (SD, $11459) for those aged 15 to 20 years. Incremental cost-effectiveness ratio values across all age groups showed that children enrolled in concurrent care had fewer live discharges but at a higher Medicaid cost of care as compared with those enrolled in standard hospice care. Concurrent hospice care was the most cost-effective in the age groups of <1 year and 1 to 5 years, with ICERs equal to $45 (95% confidence interval [CI], $23-$66) and $49 (95% CI, $8-$76), respectively. For the other older age groups, benefits of enrollment in concurrent care came at a much higher cost: in the age group of 6 to 14 years, ICER was equal to $217 (95% CI, $129-$217), and in the age group of 15 to 20 years, it was $107 (95% CI, $82-$183). Concurrent hospice is an effective way to reduce live discharges but has a higher total Medicaid cost than standard hospice care.
引用
收藏
页码:219 / 223
页数:5
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