J Hosp Palliat Nurs. 2021 Jun 1;23(3):214-220. doi: 10.1097/NJH.0000000000000738.
When the 2010 Patient Protection and Affordable Care Act (ACA) was passed, it fundamentally changed end-of-life care for children. Concurrent Care for Children (ACA, section 2302) enables Medicaid/Children's Health Insurance Program children with a prognosis of 6 months to live to use hospice care while continuing treatment for their terminal illness. Although ACA, section 2302, was enacted a decade ago, little is known about these children. The purpose of this study was to generate the first-ever national profile of children enrolled in concurrent hospice care. Using data from multiple sources, including US Medicaid data files from 2011 to 2013, a descriptive analysis of the demographic, community, hospice, and clinical characteristics of children receiving concurrent hospice care was conducted. The analysis revealed that the national sample was extremely medically complex, even for children at end of life. They received care within a complicated system involving primary care providers, hospices, and hospitals. These findings have clinical and care coordination implications for hospice nurses.
当 2010 年《患者保护与平价医疗法案》（ACA）通过时，它从根本上改变了儿童的临终关怀方式。《儿童同步护理法案》（ACA 第 2302 款）使预计生存时间为 6 个月的符合医疗补助/儿童健康保险计划的儿童能够在接受临终疾病治疗的同时使用临终关怀。尽管 ACA 第 2302 款十年前就已颁布，但对这些儿童知之甚少。本研究旨在首次生成参加同步临终关怀护理的儿童的全国概况。该研究使用了多种来源的数据，包括 2011 年至 2013 年的美国医疗补助数据文件，对接受同步临终关怀护理的儿童的人口统计学、社区、临终关怀和临床特征进行了描述性分析。分析结果表明，全国样本的医疗复杂性极高，即使是生命末期的儿童也是如此。他们在一个涉及初级保健提供者、临终关怀机构和医院的复杂系统中接受治疗。这些发现对临终关怀护士具有临床和护理协调方面的意义。
