Prendergast Louise, Crane Ellie, Bray Nathan, Noyes Jane
School of Health Sciences, Bangor University, Bangor, Gwynedd, UK.
School of Health Sciences, Bangor University, Bangor, Gwynedd, UK
BMJ Paediatr Open. 2025 Jul 16;9(1):e003526. doi: 10.1136/bmjpo-2025-003526.
To systematically review and descriptively synthesise the costs associated with any health and/or social care services provided to children with a life-limiting condition, in their last year of life.
Systematic review using MEDLINE, EMBASE, CENTRAL Cochrane Library, CINAHL and other specialist databases to identify articles published between 2004 and 2024. Duplicates were removed and two authors screened the articles and abstracts independently. Full-text articles were assessed for eligibility, with quality assessment conducted using the Drummond checklist. The findings were exported into tables and summarised narratively. Costs from each study were calculated per person per month and inflated to 2024 US dollars.
20 records were eligible for final inclusion. Services reported were varied as were approaches to estimating costs. In general, younger children required more intensive and higher cost care. Costs increase in the final months of life, and specialist paediatric palliative care interventions were associated with overall lower costs through reductions in hospital admissions and length of stay.
It was not possible to present a reliable robust estimate of the economic costs of services and resources due to limited and heterogenic data. Further research is needed to identify the full range of resources, and services associated with caring for children with life-limiting conditions in their last year of life, to support healthcare planning and resource allocation.
系统回顾并描述性综合分析为患有危及生命疾病的儿童在其生命的最后一年提供的任何健康和/或社会护理服务的相关成本。
使用MEDLINE、EMBASE、CENTRAL考科蓝图书馆、CINAHL和其他专业数据库进行系统回顾，以识别2004年至2024年期间发表的文章。去除重复项后，由两位作者独立筛选文章和摘要。对全文进行资格评估，并使用德拉蒙德清单进行质量评估。研究结果导出到表格中并进行叙述性总结。每项研究的成本按每人每月计算，并折算为2024年美元。
20条记录符合最终纳入标准。报告的服务各不相同，成本估算方法也各不相同。一般来说，年龄较小的儿童需要更密集、成本更高的护理。在生命的最后几个月成本会增加，而专业儿科姑息治疗干预措施通过减少住院次数和住院时间，总体成本较低。
由于数据有限且存在异质性，无法对服务和资源的经济成本进行可靠的精确估计。需要进一步研究以确定在患有危及生命疾病的儿童生命的最后一年中，与护理相关的全部资源和服务，以支持医疗规划和资源分配。
