A group of US researchers investigated the hospital care that children and young adults from across Washington State received in their last year of life. Their results show that while infants would benefit most from in-hospital palliative care and bereavement services, older children with long-term illnesses also need community-based and at-home services.

The authors write: "Our current population-based knowledge of pediatric end-of-life experience is severely limitedThis population-based study of end-of-life care for children provides a valuable perspective due to the breadth of its surveillance, extending beyond the confines of a single institution or a restricted range of disease conditions."

The researchers, from the Children's Hospital of Philadelphia, the Child Health Institute, and the Children's Hospital and Regional Medical Center in Seattle, studied the frequency and duration of hospital visits by people under 25 who died in Washington State between 1990 and 1996. They focused primarily on people who suffered from long-term illnesses, as these patients in particular could benefit from improvements in palliative and end of life care.

8,893 people under 25 died within the study period. A quarter of these suffered from long-term illnesses; a quarter were less than a year old.

The researchers were interested in finding out how best to identify patients who would benefit from palliative care services. One way, which would effectively identify dying newborns, was to look at when the patients were first hospitalized. 89% of newborns that died under a week of age, and 75% of newborns that died between one and four weeks old were hospitalized on their first day of life. Unfortunately, this method cannot
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BioMed Central
22-Dec-2003