Laird Jessica, Cozad Melanie J, Keim-Malpass Jessica, Mack Jennifer W, Lindley Lisa C
Jessica Laird is a nursing student in the College of Nursing at the University of Tennessee, Knoxville, in Knoxville, Tennessee.
Melanie J. Cozad is an assistant professor in the Department of Health Services Policy and the Management Center for Effectiveness Research in Orthopedics at the University of South Carolina, in Columbia, South Carolina.
Health Aff (Millwood). 2020 Oct;39(10):1770-1775. doi: 10.1377/hlthaff.2020.01192.
More than 55,000 children die each year in the United States, and hospice is used for very few of them at the end of their lives. Nearly one-third of pediatric deaths are a result of chronic, complex conditions, and the majority of these children are enrolled in Medicaid because of disability status or the severity of their disease. Changes in Medicaid/Children's Health Insurance Program regulations under Section 2302 of the Affordable Care Act require all state Medicaid plans to finance curative and hospice services for children. The section enables the option for pediatric patients to continue curative care while enrolled in hospice. We examined state-level implementation of concurrent care for Medicaid beneficiaries and found significant variability in guidelines across the US. The implementation of concurrent care has fostered innovation yet has added barriers to how pediatric concurrent care has been implemented.
在美国，每年有超过55000名儿童死亡，而临终关怀在他们生命末期的使用却非常少。近三分之一的儿科死亡是由慢性、复杂疾病导致的，这些儿童中的大多数因残疾状况或疾病严重程度而参加了医疗补助计划。《平价医疗法案》第2302条规定的医疗补助计划/儿童健康保险计划法规的变化要求所有州医疗补助计划为儿童提供治疗和临终关怀服务。该条款使儿科患者在参加临终关怀的同时能够继续接受治疗护理。我们研究了针对医疗补助计划受益人的同步护理在州一级的实施情况，发现美国各地的指导方针存在很大差异。同步护理的实施促进了创新，但也给儿科同步护理的实施增加了障碍。
