The use of hospice and palliative care is on the rise in the United States, according to a new study by the Dartmouth Atlas Project. However, disconnects between patient desires and outcomes remain commonplace.
The report finds that Medicare beneficiaries with severe and terminal chronic conditions spent fewer days in the hospital at the end of life in 2007 than 2003. However, they saw more physicians and spent more time in intensive care units, with trends exacerbated in particular parts of the country, most significantly Los Angeles; McAllen, Texas; and Miami.
The study's authors conclude that the large technological investment the healthcare system has made in prolonging life makes it institutionally difficult to switch focus.
"The healthcare industry and systems in this country have preferentially made great investments in ICU capacity, for example," David Goodman, director of the center for health policy research at the Dartmouth Institute for Health Policy and Clinical Practice, tells Healthcare Finance News.
"So while there are reasons for those investment patterns, we have to recognize that they are very problematic and they leave us with a legacy of infrastructure that's not well suited for what most patients want. ... What we need is communication with patients that is able to inform and understand whatever the patients' preferences are and then follow through on them."
For more:
- here's the study (.pdf)
- read the Healthcare Finance News article