Publication
Validation of Administrative Codes for Palliative Care Consultation Among Critically Ill Children
O'Keefe S, Czaja A · Hospital pediatrics · 2021
OBJECTIVES: To determine the validity of palliative care (PC) administrative codes (V66.7 and Z51.5) among critically ill pediatric patients. METHOD(S): In this single-center retrospective cohort study, we included all hospitalizations with a PICU admission between March 2016 and March 2018. Sensitivity, specificity, and positive and negative predictive values of the relevant codes were estimated by using a gold standard of a local PC registry. RESULT(S): During the study period, 4670 hospitalizations were included. The median admission age was 5 years (interquartile range 1.5-12.9) with 55% having at least 1 complex chronic condition. The median length of PICU stay was 1.8 days (interquartile range 1-3.4) and mortality was low (1.3%). A total 182 (3.9%) hospitalizations had evidence of a PC consultation. Administrative codes for PC had a sensitivity of 11% (95% confidence interval [CI] 6.8%-16.5%) and a specificity of 99.8% (95% CI 99.6%-99.9%). The positive and negative predictive values were 66.7% (95% CI 47.2%-82.7%) and 96.5% (95% CI 95.9%-97.0%), respectively. CONCLUSION(S): Among critically ill children, PC administrative codes had high specificity but poor sensitivity. The potential for underascertainment of this resource should be considered in future research using administrative data. Copyright © 2021 by the American Academy of Pediatrics.
Synced from the TRENDS in Pediatric Palliative Care Zotero library, curated by The Siden Research Team. ICPCN does not host or verify the full text.