1715: SPECIALIZED PALLIATIVE CARE (SPPC) AND THE IMPACT ON BEREAVED PARENTAL MENTAL AND PHYSICAL HEALTH

Introduction: Approximately 45,000 children die in the United States annually. A child’s death can lead to long-term impacts on parental mental and physical health. Despite increasing utilization of SPPC in tertiary care hospitals and ICUs, little is known about the impact of SPPC following a child’s death on the health outcomes of bereaved parents. This study aimed to assess the impact of SPPC consultation on the development of mental and physical health burden of bereaved parents. Methods: We conducted a retrospective observational cohort study of caregivers of children 0-21 years who received care in ICUs in a children’s hospital, between 2013- 2019 and died within 6 months of care. Parent and child health records were linked together through the Utah Population Database. Parental mental and physical health burden were assessed using administrative claims data in 6-month intervals for 24 months after the child’s death. Multivariable logistic regression models were used to evaluate the association of PPC on parental mental and physical health burden 12 months after the child’s death. We report here only mental health impact. Results: Of the 776 deceased children, 36.1% received a PPC consultation prior to death. Deceased children often had a chronic complex condition (n=739, 95.2%); died in-patient (n=439, 56.6%); and of natural causes (n=620, 79.9%). There were 773 mothers and 711 fathers with complete data. Mental health burden peaked for both parents during the first 6 months after the child’s death (22.9% for mothers and 10.1% for fathers, respectively) New-onset parental mental burden was observed at 6, 12, and 24 months after the child’s death, with higher rates among mothers compared to fathers across all time points (10.2% vs. 5.8%), (12.4%vs. 7.3%), (17.1 vs. 10.1%). Lack of SPPC was associated with increased risks for new mental health burden for mothers within 12 months after the child’s death (adjusted odds ratios [aOR] [95% CIs] 1.77 [1.03-3.03;p=0.038]. Conclusions: While mothers had higher rates of new mental health burden up to 24 months after the loss of a child, both parents were impacted. SPPC engagement may be helpful in reducing the development of new mental health burdens in mothers during the bereavement period.