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J Korean Med Sci. 2018 Jan 1;33(1):e1. doi: 10.3346/jkms.2018.33.e1.

Pediatric Deaths Attributed to Complex Chronic Conditions over 10 Years in Korea: Evidence for the Need to Provide Pediatric Palliative Care.

Author information

Institute of Public Health and Medical Service, Seoul National University Hospital, Seoul, Korea.
Department of Pediatrics, Seoul National University Hospital, Seoul, Korea.
Department of Medical Administration, Daejeon Health Sciences College, Daejeon, Korea.
Department of Nursing Science, Shinsung University, Dangjin, Korea.
College of Nursing, Seoul National University, Seoul, Korea.
Public Health Medical Service, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, Korea.



Pediatric palliative care (PPC) is the active total care of children suffering from life-threatening illnesses. Palliative care includes symptom management, psychosocial support, and end-of-life care. Despite significant advances in disease diagnosis and treatment, resources for PPC of children with serious illnesses are limited in Korea. This study aimed to investigate the scale, time trends, disease composition, regional distribution, and unmet needs of children dying from complex chronic conditions (CCCs).


We examined available information on children who died of CCCs from 2005 to 2014 using the cause of death statistics in Korea.


There were 36,808 cases of pediatric deaths in Korea during that 10-year period, one-third (12,515 cases, 34.0%) of which were due to CCCs. In 2014, there were 1,044 cases of pediatric deaths due to CCCs (9.8 deaths per 100,000 children) in Korea. The rate of pediatric deaths due to CCCs has declined over this 10-year period. Among CCCs, malignancy was the most common cause of death overall, as well as in children and adolescents, whereas neonatal disorders were the most common cause of death in infants. Although over 1,000 children die from chronic illnesses each year, there are no hospitals or institutes in Korea that meet the minimum standards for specialized PPC.


To improve the quality of life of children suffering from CCCs and to support their families who face enormous distress, children with CCCs should be able to access adequate palliative care services. Health authorities should consider supporting the establishment of PPC centers and increasing PPC accessibility in Korea.


Cause of Death; Children's Hospice; Complex Chronic Conditions; Pediatric Palliative Care; Pediatrics

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