Abstract
Background and objective: Pediatric palliative care (PPC) improves the quality of life for children with life-limiting conditions and their families by addressing physical, psychological, and spiritual needs. Despite increasing recognition of its benefits, PPC remains underutilized, particularly in Asian contexts where early integration and service accessibility are still limited. This study aimed to examine trends and factors influencing PPC utilization among deceased children in a tertiary children’s hospital in Taiwan from 2012 to 2023, to provide evidence on predictors for more equitable access to PPC.
Methods: A retrospective study was conducted using medical records of children aged 1–18 years who died between January 2012 and December 2023. PPC utilization was defined as enrollment in the PPC program and the duration of PPC services. Descriptive statistics summarized utilization trends. Logistic and multiple linear regression identified predictors of PPC enrollment and duration respectively.
Results: Among 411 deceased children, PPC enrollment increased from 13.3% in 2012–2015 to 41.3% in 2020–2023, representing a 3.11-fold increase, while the average duration of PPC decreased by half. Significant predictors of PPC enrollment included the introduction of a PPC case manager, parental education level, diagnosis, do-not-resuscitate (DNR) order, and cardiopulmonary resuscitation (CPR) administration. CPR administration within the last month of life was the only factor associated with PPC duration.
Conclusion: PPC enrollment at this tertiary children’s hospital has significantly increased over the past decade; however, the average duration has declined. Clinical and family-related factors influenced PPC utilization, emphasizing the need for early interventions. Strengthening case management and family-centered strategies is essential to optimize PPC accessibility and quality for children with life-limiting conditions.
Notes
References:
1. Chen, S. H., Wu, E. T., Wang, C. C., Su, M. Y., Chang, C. H., Chen, H. L., Lu, F. L., & Cheng, S. Y. (2023). Increasing Trend and Effects of Pediatric Palliative Care on Children With Noncancer Diagnoses. Journal of pain and symptom management, 66(3), 230–237.e1. https://doi.org/10.1016/j.jpainsymman.2023.05.018
2. Cuervo-Suarez, M. I., Claros-Hulbert, A., Manzano-Nunez, R., Muñoz, M., & García, X. (2020). Pediatric Palliative Care During End of Life: A Privilege of a Few in a Tertiary Referral Hospital From Colombia. The American journal of hospice & palliative care, 37(8), 636–640. https://doi.org/10.1177/1049909120920542
3. Feyereisen, S., & Puro, N. (2024). Advanced practice nurse case managers improve efforts by US hospitals to address patient social needs. Journal of advanced nursing, 80(6), 2577–2583. https://doi.org/10.1111/jan.15937
4. World Health Organization. (2023). Palliative care for children. https://www.who.int/europe/news-room/fact-sheets/item/palliative-care-for-children
5. Wu, W. W., Lu, F. L., Tang, C. C., Chao, F. H., & Yu, T. H. (2023). Pediatric palliative care utilization by decedent children: A nationwide population-based study, 2002-2017. Journal of nursing scholarship: an official publication of Sigma Theta Tau International Honor Society of Nursing, 55(6), 1116–1125. https://doi.org/10.1111/jnu.12908
6. Yu, T. H., Wei, C. J., Wu, W. W., & Lu, F. L. (2024). Does the role of family meetings important at the end-of-life? A retrospective national study in Taiwan. BMC palliative care, 23(1), 286. https://doi.org/10.1186/s12904-024-01613-1
7. Zhang, A., Bing, L., Mi, Q., Zhou, F., & Wang, J. (2021). Pediatric Palliative Care for Children with Cancer in a Children's Tertiary Hospital in China: Six-Year Experience of a Pediatric Palliative Care Service. Palliative medicine reports, 2(1), 1–8. https://doi.org/10.1089/pmr.2020.0030
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
Retrospective
Research Approach
Quantitative Research
Keywords:
Hospice, Palliative, End-of-Life, Palliative Care, Palliative Care--In Infancy and Childhood, Pediatric Care, Health Resource Utilization, Taiwan
Recommended Citation
Yang, Tzu-Ying; Wu, Wei-Wen; Lu, Frank Leigh; Cheng, Shao-Yi; Yu, Tsung-Hsien; and Berg, Kristin, "Factors Influencing Pediatric Palliative Care Utilization: A 12-Year Retrospective Study in Taiwan" (2026). International Nursing Research Congress (INRC). 50.
https://www.sigmarepository.org/inrc/2026/posters_2026/50
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Publisher-submission
Date of Issue
2026-07-30
Factors Influencing Pediatric Palliative Care Utilization: A 12-Year Retrospective Study in Taiwan
Toronto, Ontario, Canada
Background and objective: Pediatric palliative care (PPC) improves the quality of life for children with life-limiting conditions and their families by addressing physical, psychological, and spiritual needs. Despite increasing recognition of its benefits, PPC remains underutilized, particularly in Asian contexts where early integration and service accessibility are still limited. This study aimed to examine trends and factors influencing PPC utilization among deceased children in a tertiary children’s hospital in Taiwan from 2012 to 2023, to provide evidence on predictors for more equitable access to PPC.
Methods: A retrospective study was conducted using medical records of children aged 1–18 years who died between January 2012 and December 2023. PPC utilization was defined as enrollment in the PPC program and the duration of PPC services. Descriptive statistics summarized utilization trends. Logistic and multiple linear regression identified predictors of PPC enrollment and duration respectively.
Results: Among 411 deceased children, PPC enrollment increased from 13.3% in 2012–2015 to 41.3% in 2020–2023, representing a 3.11-fold increase, while the average duration of PPC decreased by half. Significant predictors of PPC enrollment included the introduction of a PPC case manager, parental education level, diagnosis, do-not-resuscitate (DNR) order, and cardiopulmonary resuscitation (CPR) administration. CPR administration within the last month of life was the only factor associated with PPC duration.
Conclusion: PPC enrollment at this tertiary children’s hospital has significantly increased over the past decade; however, the average duration has declined. Clinical and family-related factors influenced PPC utilization, emphasizing the need for early interventions. Strengthening case management and family-centered strategies is essential to optimize PPC accessibility and quality for children with life-limiting conditions.
Description
This 12-year retrospective study examined pediatric palliative care utilization among deceased children in a tertiary children’s hospital in Taiwan. Findings revealed a threefold increase in PPC enrollment but a shorter duration of care. Predictors included case manager introduction, parental education, diagnosis, DNR order and CPR administration. Results provide insight into factors shaping timely referrals and highlight the nursing role in advancing pediatric palliative care.