| Autor: |
Svynarenko R; College of Nursing, University of Tennessee, Knoxville, TN, USA., Cozad MJ; Department of Health Services Research and Administration, University of Nebraska Medical Center, Omaha, NE, USA., Mack JW; Department of Pediatric Oncology and Division of Population Sciences, Dana-Farber Cancer Institute, Boston Children's Hospital, Boston, MA, USA., Keim-Malpass J; School of Nursing, University of Virginia, Charlottesville, VA, USA., Hinds PS; Department of Nursing Science, Children's National Hospital, Washington, DC, USA.; Department of Pediatrics, The George Washington University, Washington, DC, USA., Lindley LC; College of Nursing, University of Tennessee, Knoxville, TN, USA. |
| Abstrakt: |
Instrumental variable analysis (IVA) has been widely used in many fields, including health care, to determine the comparative effectiveness of a treatment, intervention, or policy. However, its application in pediatric end-of-life care research has been limited. This article provides a brief overview of IVA and its assumptions. It illustrates the use of IVA by investigating the comparative effectiveness of concurrent versus standard hospice care for reducing 1-day hospice enrollments. Concurrent hospice care is a relatively recent type of care enabled by the Affordable Care Act in 2010 for children enrolled in the Medicaid program and allows for receiving life-prolonging medical treatment concurrently with hospice care. The IVA was conducted using observational data from 18,152 pediatric patients enrolled in hospice between 2011 and 2013. The results indicated that enrollment in concurrent hospice care reduced 1-day enrollment by 19.3%. |
