Featured Research

from universities, journals, and other organizations

Children With Serious Complex Illness More Likely Than Before To Die At Home Than In The Hospital

Date:
June 27, 2007
Source:
Children's Hospital of Philadelphia
Summary:
Children who die of a chronic illness are more likely to spend their final days at home compared to children who died two decades ago. Overall, a majority of chronically ill children still die in hospitals, with African-American and Hispanic patients continuing to be less likely than white patients to die at home. However, the shift in place of death raises questions about how to best provide care and resources for very sick children.

Children who die of a chronic illness are more likely to spend their final days at home compared to children who died two decades ago.

Related Articles


Overall, a majority of chronically ill children still die in hospitals, with African American and Hispanic patients continuing to be less likely than white patients to die at home. However, the shifting trend in place of death raises questions for families, medical caregivers and policy-makers about how to best provide care and resources for very sick children.

"There has been a quiet transformation in care for children with severe chronic conditions," said pediatrician Chris Feudtner, M.D., Ph.D., M.P.H., lead author of the study in the June 27 Journal of the American Medical Association. "Advances in medicine and technology are extending survival, as well as allowing medically fragile children to live at home. In addition, shifts in attitudes about palliative and end-of-life care may also be affecting both how these children live and whether they may die at home." Palliative care focuses on relieving symptoms, improving comfort and enhancing quality of life when a cure is not possible.

Feudtner's study team analyzed national health records for 198,000 U.S. children whose deaths were attributed to a complex chronic condition between 1989 and 2003. Those conditions include heart disease, cancer, neuromuscular diseases that worsen over time, and genetic illnesses, among others.

Over 15 years, the proportion of chronically ill children dying at home increased significantly for each age group, from 4.9 percent to 7.3 percent among infants, from 17.9 percent to 30.7 percent for ages one to nine, and from 18.4 percent to 32.2 percent among 10- to 19-year-olds. This was the first time the sites of death were studied for a national population of children with chronic diseases.

"Although there is a clear trend toward higher proportions of medically fragile children dying at home, our research does not support a value judgment that dying at home is preferable to dying in a hospital," said Feudtner, a prominent advocate for improving quality of care for children with life-limiting conditions. "We want each family to be able to make care decisions based on their own values, wishes and preferences, and medical professionals should collaborate with patients and families in helping them make decisions in an atmosphere of mutual understanding, trust and respect."

Over the 15-year period covered by the study, significant racial and ethnic disparities persisted, with the odds of dying at home remaining significantly lower among black and Hispanic children compared to white children. "This study cannot tell us why these racial and ethnic disparities exist," said Feudtner. "If they reflect different preferences among these groups, then the differences would be much less worrisome than if the disparities are linked to poorer economic or social resources, or to reduced access to health care services and medical technology."

Feudtner concludes that the findings of the study underscore that much remains to be learned and accomplished in the field: "We clearly need more research to better understand family and patient needs, and to improve the quality of care for chronically ill children, whether they are at home or in the hospital."


Story Source:

The above story is based on materials provided by Children's Hospital of Philadelphia. Note: Materials may be edited for content and length.


Cite This Page:

Children's Hospital of Philadelphia. "Children With Serious Complex Illness More Likely Than Before To Die At Home Than In The Hospital." ScienceDaily. ScienceDaily, 27 June 2007. <www.sciencedaily.com/releases/2007/06/070626115356.htm>.
Children's Hospital of Philadelphia. (2007, June 27). Children With Serious Complex Illness More Likely Than Before To Die At Home Than In The Hospital. ScienceDaily. Retrieved March 2, 2015 from www.sciencedaily.com/releases/2007/06/070626115356.htm
Children's Hospital of Philadelphia. "Children With Serious Complex Illness More Likely Than Before To Die At Home Than In The Hospital." ScienceDaily. www.sciencedaily.com/releases/2007/06/070626115356.htm (accessed March 2, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Monday, March 2, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Treadmill Test Can Predict Chance Of Death Within A Decade

Treadmill Test Can Predict Chance Of Death Within A Decade

Newsy (Mar. 2, 2015) Johns Hopkins researchers analyzed 58,000 heart stress tests to come up with a formula that predicts a person&apos;s chances of dying in the next decade. Video provided by Newsy
Powered by NewsLook.com
Going Gluten-Free Could Get You A Tax Break

Going Gluten-Free Could Get You A Tax Break

Newsy (Mar. 2, 2015) If a doctor advises you to remove gluten from your diet, you could get a tax deduction on the amount you spend on gluten-free foods. Video provided by Newsy
Powered by NewsLook.com
GlaxoSmithKline and Novartis Try Swapping Success

GlaxoSmithKline and Novartis Try Swapping Success

Reuters - Business Video Online (Mar. 2, 2015) GlaxoSmithKline and Novartis have completed a series of asset swaps worth more than $20 billion. As Grace Pascoe reports they say the deal will reshape both drugmakers. Video provided by Reuters
Powered by NewsLook.com
How Can West Africa Rebuild After Ebola?

How Can West Africa Rebuild After Ebola?

Reuters - Business Video Online (Mar. 2, 2015) How best to rebuild the three West African countries struggling with Ebola will be discussed in Brussels this week. As Hayley Platt reports Sierra Leone has the toughest job ahead - its once thriving economy has been ravaged by the disease. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins