Table 3: Effect of pediatric palliative care programs versus usual care on admissions
Study*SummaryOutcome
Arland et al. (10)Decrease54% with admissions before program (5 yr) v. 29% after program (10 yr); < 0.05
46% fewer admissions
Dussel et al. (14)No difference/
controversial
54% (47/87) with admissions in intervention group v. 98% (51/52) in control group; < 0.001
No difference in emergency department visits: 6% (5/84) v. 16% (8/50); = 0.057
Keele et al. (12)DecreaseRelative risk of ICU admissions lower in intervention group: 0.29 (95% CI 0.26–0.32)
Smith A et al. (19)No difference/
controversial
PICU admissions: 90% (73/93) of patients in intervention group v. 56% (522/920) in control group; p < 0.001
NICU admissions: 17% (14/93) in intervention group v. 28% (262/920) in control group; p = 0.04
Postier et al. (18)No difference/
controversial
Mean no. of admissions ± SD: 3.09 ± 3.6 before v. 3.18 ± 4.3 after intervention; = 0.538
Interaction: level of exposure to program, cancer or not, study period (p < 0.001), adjusting for other demographic and clinical characteristics
Fraser LK et al. (11)No difference/
controversial
Total hospital admissions (controlled for age, disease, sex, deprivation category): IRR 0.79 (CI 95% 0.59 to 1.05); = 0.10
Planned hospital admissions: IRR 0.60 (CI 95% 0.43 to 0.85); = 0.004
Emergency department visits: IRR 1.15 (CI 95% 0.84 to 1.58); p = 0.375
Pascuet E et al. (13)No difference/
controversial
Median no. of emergency department visits per month after intervention: –0.03 (95% CI –0.09 to 0.02); = 0.20
Median no. of outpatient visits per month after intervention –0.5 (95% CI –1.0 to –0.05): p = 0.029

Note: CI = confidence interval, ICU = intensive care unit, IRR = incidence rate ratio, NICU = neonatal intensive care unit, PICU = pediatric intensive care unit.
*Studies listed according to outcome measurement and quality-assessment rank.