Predictors of length of home and hospital stay, types of services received, cost and family response in an established pediatric hospice program.

Belinda Barry Martin, RN, MS, is Home Care Coordinator at Childrens Hospital of Los Angeles, Los Angeles, California. Although many studies have documented aspects of adult hospice care, there is little data available about the patterns of care for terminally ill children and the family response to this type of pediatric care. Pediatric hospice care differs in two notable ways from adult hospice care: (1) use of aggressive therapy; and (2) no six-month prognosis restriction. These differences, together with the different family roles between parent and child, make it difficult to generalize from data on adult hospice care to pediatric hospice care. The purpose of this demonstration model research study was: (1) to describe the characteristics of patients and families served over a five-year period, the types and intensity of services provided for home care, the length of stay in the home and in the hospital after entering the program, the costs of home care services, and the family responses to the program and its services; and (2) to examine the relationship between medical and background characteristics and patterns and costs of care. The design for this study was a retrospective crosssectional design. Data for the study were collected from three sources: (1) hospital and hospice program records; (2) home health care records; and (3) telephone interview data. The population studies