Pediatric Home Hospice as a National Service in Israel
Bibliographic record
Abstract
Background: Pediatric home hospice allows children with life-limiting illnesses to receive end-of-life care in familiar surroundings, supported by interprofessional teams. Despite recognized benefits, utilization remained limited in many countries, and few studies evaluated national programs outside of Europe and North America. Objectives: To describe the characteristics, service utilization patterns, and end-of-life outcomes of children enrolled in Israel’s largest pediatric home hospice program over a 12-year period. Methods: This retrospective cohort study included all patients aged 0–21 years enrolled in the Sabar Health pediatric home hospice program between 2012 and 2023. Data were extracted from clinical and administrative records and included age, sex, diagnosis, ethnicity, length of stay (LOS), place of death, and discharge status. Descriptive statistics and group comparisons were performed using chi-square and Mann–Whitney U tests. Results: The cohort included 277 patients, of whom 221 (79.8%) had cancer and 56 (20.2%) had non-cancer diagnoses. The median LOS was 40 days (interquartile range [IQR]: 12–89) for cancer patients ( p = 0.012) and 84 days (IQR: 20–173) for non-cancer patients. Among the 201 patients who died on hospice, 96 of 221 had cancer (43.4%), and 17 of 56 had non-cancer diagnoses (30.4%). Live discharge occurred in 50 of 221 cancer patients (22.6%) and in 26 of 56 non-cancer patients (46.4%). Most patients were older than five years ( n = 228, 82.3%). Conclusions: This study highlights that pediatric home hospice in Israel primarily serves older children and those with cancer diagnoses, while younger children and those with non-cancer diagnoses are less likely to access these services. They are also less likely to die at home. These findings emphasize the need for flexible, diagnosis, and age-sensitive hospice models with early recognition of relevant patients. System-level investment is essential to align pediatric hospice care with clinical realities and family preferences.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".