Access to hospital beds may lead to overtreatment, unnecessary care

More people in New York and New Jersey die in the hospital because the region has more than enough beds to offer, leading to more tests, treatments, prescriptions and people dying in the intensive care unit on a feeding tube or a ventilator, Kaiser Health News, National Public Radio and WNYC reported.

"One of the truisms of healthcare is that whatever resources are available, or whatever beds are built, they tend to get filled," David Goodman, M.D., who studies end-of-life care at Dartmouth College's Geisel School of Medicine, told KHN.

Another reason is that the New York region also has its own medical culture, in which highly trained specialists who see it as their job to cure illness and find a solution to every problem. Diane Meier, M.D., a geriatric specialist at Mount Sinai and director of the Center to Advance Palliative Care, said specialists who refer patients to each other also drive the high treatment rate.

But as value-based care takes the place of the fee-for-service model, which penalizes high admissions, New York regional hospitals must adapt. At Mt. Sinai, Meier said surgical staff must discuss hospice options and end-of-life care with terminally ill patients and make a note of the conversation in their charts--those conversations could save a lot of pain and suffering, as well as millions of dollars in useless tests and treatments.

The article comes on the heels of the Institute of Medicine's report, "Dying in America," which recommends that doctors and hospitals put more focus on discussing end-of-life and palliative care with patients. "The bottom line is the healthcare system is poorly designed to meet the needs of patients near the end of life," said David M. Walker, a former United States comptroller general and chairman of the 21-person panel that released the report, FierceHealthcare previously reported. "The current system is geared towards doing more, more, more, and that system by definition is not necessarily consistent with what patients want, and is also more costly."

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