The immediate benefits of Make-A-Wish Foundation dreams to sick children and their families are well documented.
But it appears they could also bring some sustained health benefits resulting in fewer unplanned admissions and emergency department visits among seriously ill pediatric patients, a recent study found.
Published in the Journal of Pediatric Research, the retrospective study from researchers at Nationwide Children's Hospital found patients granted a wish were 2.5 times more likely to have fewer unplanned hospital admissions and 1.9 times more likely not to have to use the emergency department.
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Lead author Anup Patel, M.D., section chief of neurology at Nationwide Children’s Hospital, specializes in treating kids with epilepsy who have between a 1% and 3% chance of ever becoming seizure-free. He is also an outcomes researcher specializing in different interventions to see what impact they have on healthcare.
He'd started being able to offer wishes to kids and noticed from his own experiences that the kids were changed when they came back.
"They were either having less seizures or, in some cases, they weren't having any seizures. But they were also happier, lighter, engaged. I saw it over and over. As a researcher, I started to ask the question: I wonder if you can actually measure the impact of a wish?"
One 15-year-old patient in particular who had daily seizures that were reducing her quality of life began suffering from depression. Her wish was to go to Paris and, shockingly, she didn't have a seizure once during her trip, Patel said. "It was the most amazing thing I'd seen," he said about the patient, who has given permission to talk about her story. "She still is doing much better and I've been able to take her off some of the medicines she was on because she's doing so well."
The study compared patients who received or did not receive a wish and associated impact on healthcare utilization and costs across two years. Looking at the electronic health record database from 2011 to 2016, 496 Nationwide Children’s Hospital patients received a wish. These were matched to the same number of a control group based on age, gender, disease category and disease complexity.
The average cost of a granted "wish" is a little more than $10,000. By his study's calculation, there was a decrease in the cost of care of about $10,130 two years after a wish is granted.
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The study also looked at different wish categories and disease states and found there did not seem to be differences in the effects.
However, Patel said, there were some limitations to the retrospective study. When seeking to compare the impact of different categories of wishes such as an experience like meeting a celebrity or getting an item like a tree house in the backyard, the vast majority of children selected trips for their wishes. That made it difficult to observe the difference in effect between the different kinds of wishes.
And although in the adult population studies find the effects of relaxation or joy from travel fade rather quickly with much of those benefits coming from the anticipation of the travels, Patel said more research is needed to understand why there seems to be such a sustained benefit in these children.
"My theory is, a lot of these families when they go there get connected to each other and I think there's a benefit to that. Or perhaps their more engaged with the medical team so perhaps they are more likely to listen to me and take their treatments on a regular basis," he said. "But then there is this power of hope which is difficult to measure in a study that when these families get these experiences, it just changes their outlook and well-being. They get a break from their illness and that empowers them. That empowerment, I think, is longstanding and beneficial."
Patel said he hopes the findings could further open up research into other treatment avenues for pediatric patients, because he saw such a surprisingly positive financial impact in addition to the impact on children's health and well-being. He also hopes the study will convince other health systems to take a harder look at adding wishes to the treatment plans of their pediatric patients.
"That tells me this is an investment worth making," Patel said.