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Effectiveness of end-of-life strategies to improve pediatric health outcomes and reduce disparities in rural Appalachia
Investigator (PI): Lindley, Lisa C
Performing Organization (PO): (Current): University of Tennessee, Knoxville, College of Nursing / (865) 974-4151
Supporting Agency (SA): National Institutes of Health (NIH), National Institute of Nursing Research (NINR)
Initial Year: 2020
Final Year: 2022
Record Source/Award ID: RePorter/ R56NR019444
Funding: 2020 Award Amount: $293,301
Award Type: Grant
Abstract: Rural Appalachia has struggled with health and health care access for more than a century. For children, lack of access to health care services starts at birth with limited prenatal care resources and continues to end of life with restricted access to pediatric hospice. The main objective of this study is to investigate the effect of expanding access to pediatric hospice care (concurrent care) to reduce rural/urban disparities in child and adolescent health outcomes (symptom management, care continuity, and costs). To do this, we will obtain, link, and analyze data from a variety of sources, including 2011-2014 Medicaid data, U.S. Census, and hospice provider files. We will employ geographic information systems and comparative effectiveness data analytic methods, in which we will control for patient/family, hospice provider, and community characteristics. A unique aspect of our proposed study is the use of mapping techniques to visualize rural/urban disparities in access to pediatric hospice care in Appalachia. By examining these data, we will be able to assess impact of concurrent care on rural/urban disparities and health outcomes in a significantly underserved populations. As the health of children and adolescents continues to decline in the Appalachian region, this information is of major importance to clinicians, policy makers, and families. This line of investigation is expected to ultimately improve the quality care for children, adolescents, and their families at end of life in Appalachia.
MeSH Terms:
  • * Access to Health Care
  • Appalachia
  • Comparative Effectiveness Research
  • Geographic Information Systems
  • Health Care Disparities
  • Health Policy
  • Health Status Disparities
  • Hospice
  • Humans
  • Medicaid
  • Medically Underserved Area
  • * Outcome Assessment (Health Care)
  • Pediatrics /*methods
  • /*organization & administration
  • Quality of Health Care
  • Rural Population
  • Terminal Care /*methods
  • /*organization & administration
  • United States
  • Urban Population
Country: United States
State: Tennessee
Zip Code: 37996
UI: 20211265
Project Status: Ongoing