Hospitals Often Provide More End-of-Life Care Than Necessary

Main Category: Palliative Care / Hospice Care
Also Included In: Seniors / Aging;  Public Health
Article Date: 16 Nov 2006 - 11:00 PDT

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The St. Paul Pioneer Press on Sunday examined how a recent study indicates that "hospitals that provide more intense care do not prolong life for patients with chronic or terminal illnesses." According to a study conducted by Dartmouth Atlas, Medicare could spend $19 billion less on end-of-life care for beneficiaries and obtain the same outcomes (Olson, St. Paul Pioneer Press, 11/12). For the study, Dartmouth Medical School researchers examined records of hospital care, tests and physician visits provided to 4.7 million Medicare beneficiaries during the last two years of their lives. Study participants, who were ages 67 and older, had at least one of 12 chronic illnesses and died between 2000 and 2003 (Kaiser Daily Health Policy Report, 5/16). The study found 5% higher mortality rates among heart attack and colon cancer patients who received the most care. Elliot Fisher of Dartmouth Atlas said, "The paradox of modern medicine is that as our technology gets better and better and is able to do more and more, we're moving to a clinical paradigm that really does a worse and worse job of taking care of people and the illnesses they are experiencing." According to the Pioneer Press, the study has prompted some health insurers to provide financial incentives for physicians who are "more thoughtful when advising patients about medical care at the end of life" because currently they "get paid for procedures whether or not they prolong life," as well as for the treatment of any complications from those procedures. Some health policy experts also have recommended that health insurers begin to cover palliative care, which focuses on pain management and helps patients consider their options for end-of-life care. Lyn Ceronsky, director of a palliative care program at the University of Minnesota Medical Center, Fairview, said, "It's never 'We don't think you need this,'" adding, "It's 'What are your goals and how can we make sure our care plan really matches them?'" (Olson, St. Paul Pioneer Press, 11/12).

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