426 - Access to Pediatric Hospice Care in Kansas and West-Central Missouri: Identification of Deserts and Looking at Disparities

Publication Number: 426.3902

Kelstan Ellis, Childrens Mercy Kansas City, Leawood, KS, United States; Sarah Pearson, Children's Mercy Hospital, Overland Park, KS, United States; Danielle C H. Warner, Children's Mercy Hospitals and Clinics, Blue Springs, MO, United States; James D. Fluker, Children's Mercy Hospitals and Clinics, Kansas City, MO, United States; Jennifer S. Linebarger, Children's Mercy Kansas City, Kansas City, MO, United States

Background: Pediatric hospice and palliative care is a growing field, yet there is little known about the availability of these services in the community, particularly in the Midwest. Previous studies demonstrated significant barriers to providing this care include lack of pediatric providers and limited consultant expertise availability, especially in rural areas. The Palliative Care Team (PaCT) at Children’s Mercy provides inpatient and outpatient palliative care to more than 500 patients primarily in Kansas and Missouri, receiving nearly 300 new patient consults annually. Little is known about the community-based services across this catchment area.

Objective: The purpose of this study is to characterize pediatric hospice care services across Kansas and west-central Missouri as well as identify hospice deserts and disparities in access to care that exist.

Design/Methods: PaCT contacted all hospice agencies listed in the national Medicaid website for the state of Kansas and the agencies in Missouri with area codes of 816, 417, 573 and 660. We gathered additional information about pediatric hospice services provided by each agency. Coverage areas were identified by counties. The number of agencies providing pediatric hospice services in each county was calculated and mapped. These maps were then compared to demographic and socioeconomic data from these counties to identify disparities and trends.

Results: In west-central Missouri, 53 hospice agencies report providing some amount of pediatric hospice care, covering 113 of 114 counties in the studied area. In Kansas 28 agencies provide some pediatric hospice care, covering 101 of 105 counties in the state. A total of 5 counties in the study area have no pediatric hospice coverage and 45 have only one agency that reports providing pediatric services. The scope of pediatric coverage varies from agencies that have never before provided care to a pediatric patient to those with dedicated pediatric hospices. 107 agencies expressed interest in receiving education and support for providing pediatric care.

Conclusion(s): Hospice deserts exist within Kansas, specifically in Cloud, Mitchell, Jewell and Lincoln counties with many areas likely under-resourced to meet the needs of pediatric patients. A better understanding of barriers to providing and accessing pediatric hospice care is needed. Our team is currently conducting a needs assessment of the agencies surveyed in this project to identify opportunities to enhance pediatric hospice and home palliative care in the Midwest.

Availability of Pediatric Hospice Services by County in Kansas and West-Central Missouri
Range of hospice agencies providing pediatric services throughout the Children's Mercy patient catchment area.