Paediatricians’ perceptions on referrals to paediatric palliative care

Children have traditionally been referred to palliative care when curative treatments were exhausted. Recently, experts have suggested that children could benefit from palliative care early in their courses of illness. Using survey data from 303 paediatricians in Florida and California, this study assesses if paediatricians would refer children to palliative care early in their course of illness. Results showed that more years in practice were associated with decreased odds of referring children to palliative care. Academic practice setting and more Medicaid patients were associated with greater odds of referral prior to the end of life. Hispanic paediatricians, those with more experience and those who practice in a hospital setting were associated with decreased odds of referral prior to the end of life. Results suggest that health planners who wish to implement or refine integrated paediatric palliative care programs should consider outreach strategies targeted at paediatricians with specific characteristics.

[1]  C. Knapp,et al.  Pediatricians' Perceptions of and Preferred Timing for Pediatric Palliative Care , 2009, Pediatrics.

[2]  M. A. Bowman,et al.  Pediatric Palliative Care: An Assessment of Physicians' Confidence in Skills, Desire for Training, and Willingness to Refer for End-of-Life Care , 2008, The American journal of hospice & palliative care.

[3]  P. Callery,et al.  Parenting children requiring complex care: a journey through time. , 2008, Child: care, health and development.

[4]  T. Kang,et al.  Psychosocial and spiritual needs of children living with a life-limiting illness. , 2007, Pediatric clinics of North America.

[5]  B. Carter,et al.  Utility of morbidity and mortality conference in end-of-life education in the neonatal intensive care unit. , 2007, Journal of palliative medicine.

[6]  K. Poehling,et al.  Hospice referral practices for children with cancer: a survey of pediatric oncologists. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[7]  Bernard Guyer,et al.  Annual Summary of Vital Statistics: 2004 , 2006, Pediatrics.

[8]  J. P. Donnelly,et al.  The needs of children with life-limiting conditions: A healthcare-provider-based model , 2005, The American journal of hospice & palliative care.

[9]  V. Feeg,et al.  Exploratory study on end-of-life issues: Barriers to palliative care and advance directives , 2005, The American journal of hospice & palliative care.

[10]  H. Tuomainen,et al.  Meeting the Needs of Parents Around the Time of Diagnosis of Disability Among Their Children: Evaluation of a Novel Program for Information, Support, and Liaison by Key Workers , 2004, Pediatrics.

[11]  L. Ackerson,et al.  Barriers to hospice care and referrals: survey of physicians' knowledge, attitudes, and perceptions in a health maintenance organization. , 2004, Journal of palliative medicine.

[12]  D. Weissman,et al.  Pediatric palliative care. , 2004, The New England journal of medicine.

[13]  H. Irving,et al.  The dying child: how is care different? , 2003, The Medical journal of Australia.

[14]  T. L. Chambers When Children Die: Improving Palliative and End-of-Life care for Children and their Families , 2003 .

[15]  B. Mavis,et al.  Hospice and primary care physicians: Attitudes, knowledge, and barriers , 2003, The American journal of hospice & palliative care.

[16]  C. Todd,et al.  Defining patients as palliative: hospital doctors' versus general practitioners' perceptions , 2002, Palliative medicine.

[17]  Betsy T Friedman,et al.  Barriers and enablers to hospice referrals: an expert overview. , 2002, Journal of palliative medicine.

[18]  B. Mavis,et al.  Physicians and hospice care: attitudes, knowledge, and referrals. , 2002, Journal of palliative medicine.

[19]  R. Kirby,et al.  End-of-life care for neonates and infants: the experience and effects of a palliative care consultation service. , 2001, Pediatrics.

[20]  K. Forbes,et al.  Palliative care for patients with non-malignant disease: will hospital physicians refer? , 2001, Palliative medicine.

[21]  B. Wilfond,et al.  Palliative Care for Children , 2000, Pediatrics.

[22]  E. Pugh,et al.  An Investigation of General Practitioner Referrals to Palliative Care Services , 1996, Palliative medicine.

[23]  J. V. Von Roenn,et al.  Hospice and palliative care: Attitudes and practices of the physician faculty of an academic hospital , 1995, The American journal of hospice & palliative care.

[24]  M. Moncrieff Life threatening illness and hospice care. , 1990, Archives of disease in childhood.

[25]  S. Asch,et al.  Cash and Compassion , 2002 .

[26]  L. Hayman End-of-Life Care for Neonates and Infants: The Experience and Effects of a Palliative Care Consultation Service , 2002 .

[27]  S. Leuthner,et al.  Experience with neonatal palliative care consultation at the Medical College of Wisconsin-Children's Hospital of Wisconsin. , 2001, Journal of palliative medicine.

[28]  American Academy of Pediatrics. Committee on Bioethics and Committee on Hospital Care. Palliative care for children. , 2000, Pediatrics.