concurrent hospice care, health care value, pediatric, value assessment framework



  1. Sharp, Whitney Stone BSN, RN, CPN
  2. Svynarenko, Radion PhD
  3. Fornehed, Mary Lou Clark PhD, RN, ACNP-BC
  4. Cozad, Melanie J. PhD
  5. Keim-Malpass, Jessica PhD, RN
  6. Mack, Jennifer W. MD, MPH
  7. Hinds, Pamela S. PhD, RN
  8. Mooney-Doyle, Kim PhD, RN, CPNP-AC
  9. Mendola, Annette PhD, HEC-C
  10. Lindley, Lisa C. PhD, RN, FPCN, FAAN


Given that pediatric concurrent hospice care has been available for more than a decade, it is appropriate to seek an understanding of the value of this care delivery approach. Value is the cost associated with achieving beneficial health outcomes. In pursuit of this goal, the current literature on pediatric concurrent hospice care was synthesized and used to develop a model to explain its value. Because of its relevance, the Value Assessment Framework was used to conceptualize the value of pediatric concurrent hospice care. This framework gauges the value of a health care service through 2 components: long-term effect and short-term affordability. The framework considers comparative clinical effectiveness, cost-effectiveness, other benefits or disadvantages, contextual considerations, and potential budget impact. Evidence from the literature suggested that the value of concurrent care depended on clinical outcomes evaluated, costs examined, medical services used, care coordinated, context considered, and budget impacted. The literature demonstrated that pediatric concurrent hospice care does offer significant value for children and their families. The conceptual model highlighted the need for a comprehensive approach to assessing value. The model is a useful framework for future research examining the value of concurrent hospice care.