Original Article The Effect of Pediatric Knowledge on Hospice Care

The cost of hospice care is rising. Although providing care for children at end of life may be costly for hospices, it is unclear whether or not gaining pediatric knowledge and even establishing a pediatric program may be done cost effectively. The purpose of our study was to examine the effect of possessing pediatric knowledge (i.e., pediatric program, pediatric experience) on core hospice care costs. Using 2002 to 2008 California hospice data, the findings of the regression analysis suggest that having pediatric knowledge does not significantly increase nursing, physician, and medical social service costs. Having a pediatric program was related to increased counseling costs. Our findings shed important light on the minimal costs incurred when hospices decide to develop pediatric knowledge. Keywords children, cost analysis, hospice care, end of life, pediatric knowledge, core hospice services The cost of hospice care is rising. The current conversation on hospice costs has focused on cost drivers such as patient enroll-ment1; however, core hospice services—those services that Medicare and Medicaid require to be offered to patients—are often substantial expenses incurred by the hospices,2,3 and littl