• Ana Milena Sanchez Varela, Allison M Deal, Laura C Hanson, Julie Blatt, Stuart Gold, and Elisabeth P Dellon.
• Division of Pediatric Hematology and Oncology, University of North Carolina at Chapel Hill, 27599, USA. asanchez@unch.unc.edu
• Am J Hosp Palliat Care. 2012 May 1;29(3):171-6.

AbstractDespite improving organization of hospice for children with life-limiting illnesses, services may be underutilized. We asked representatives of all 76 existing North Carolina hospice organizations about barriers to serving children. Representatives of 61 agencies responded (80%). Hospices serving children differed from hospices not serving children on perception of barriers: 1) Lack of pediatric trained staff (8% vs 42%, p = 0.01); 2) lack of pediatrician consultation (23% vs 50%, p = 0.03); 3) lack of pediatric pharmacy (4% vs 32%, p = 0.006), and inconsistent plan of care between pediatrician and hospice (12% vs 47%, p = 0.01). Lack of pediatric referrals (78%) and families wanting to continue curative therapies while receiving hospice care (77%) were felt to be the most important barriers overall. Enhanced training of pediatric providers and a model of care which blends disease-specific treatment with hospice may improve access to hospice services for children.

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