Population-Level Analysis of Appropriateness of End-of-Life Care for Children with Neurologic Conditions - 19/04/23
, Tinne Smets, PhD 1, Luc Deliens, PhD 1, Gerlant van Berlaer, MD, PhD 2, Kim Beernaert, PhD 1, ∗, Joachim Cohen, PhD 1, ∗Abstract |
Objective |
The objective of this study was to measure the appropriateness of end-of-life care for children who died with neurologic conditions.
Study design |
Based on linked routinely collected databases, we conducted a population-level decedent retrospective cohort study of children with neurologic conditions who died in Belgium between 2010 and 2017. We measured a set of 22 face-validated quality indicators. The set concerns 12 indicators of potentially appropriate end-of-life care (eg, specialized comfort medication, physician contact, continuous care) and 10 indicators of potentially inappropriate end-of-life care (eg, diagnostic tests, phlebotomy). We performed ANOVA for predictors (age, sex, disease category, nationality, having siblings, year of death) for scales of appropriate and inappropriate care.
Results |
Between 2010 and 2017, 139 children with neurologic conditions died in Belgium. For potentially appropriate care, in the last 30 days, 76% of children received clinical care, 55% had continuous care relationships, 17% had contact with a general physician, 8% of children received specialized comfort medication, and 14% received care from a palliative care team. For potentially inappropriate care, in the last 14 days, 45% had blood drawn and 27% were admitted to intensive care unit.
Conclusions |
Our study found indications of appropriate as well as inappropriate end-of-life care for children who died with neurologic conditions. These findings reveal a substantial margin for potential quality improvement, in regard to palliative care provision, multidisciplinary care, financial support, specialized comfort medication, clinical follow-up, general physician contact, diagnostics, and blood drawing.
Le texte complet de cet article est disponible en PDF.Keywords : indicators, quality of care, cohort decedent study
Plan
| All phases of this study were supported by the Research Foundation Flanders (FWO postdoctoral status to K.B.). The study sponsors had no role in the study design, or the collection, analysis, and interpretation of data; the writing of the report; or the decision to submit the manuscript for publication. K.B. is a Postdoctoral Fellow of the Research Foundation Flanders (FWO). The authors declare no conflicts of interest. |
Vol 255
P. 128 - avril 2023 Retour au numéro
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