A new study from the Mayo Clinic reports that intensive care accounts for 30 to 40 percent of hospital spending, with the majority of care given to elderly patients with chronic conditions. In Olmsted County, NY, where the Mayo Clinic is based, patients in the last year of life accounted for one of every four days spent in the ICU. Treatment in this expensive setting contributes to the overall rise in healthcare costs. In another recent conducted study by the Center for the Evaluative Clinical Sciences (CECS), the authors concluded that "a fundamental problem, and one that contributes to both overspending and worse outcomes, is that most acute care hospitals have become first-line providers of services to chronically-ill elderly people, whose care would be better managed, safer and less expensive outside the hospital setting."
These studies call into question the best method for handling end-of-life care. Clearly, taking care of chronically ill patients in a hospital setting doesn't carry a substantial benefit for anyone involved. For one thing, it's a substantial drain on the Medicaid program, which is projected to run out of money by 2018. But this isn't simply a question of saving money to preserve federal funding. While elderly and chronically ill patients deserve the best care possible, often that doesn't mean more tests, more medications and longer hospitalizations. Instead, hospice care, nursing homes and palliative care could be more effective and financially responsible alternatives to expensive end-of-life ICU care.