Earlier this week, David Tribble, the chief medical officer at Alive Hospice, wrote about a study that appeared in the March 9 Archives of Internal Medicine regarding end-of-life care discussions between patients and their doctors. The study concluded that patients who reported discussing end of life with their doctors had lower health care costs. Also, patients whose health care costs were higher had a worse quality of death. Tribble comments:
This study quantifies an issue that has been avoided largely: that Americans spend more time and money on high-tech end-of-life heroics than the rest of the world combined, and do not live any longer for it. Hospice care is not anti-technology, anti-survival, or anti-hope. It is a call for us to look seriously at what works. The fact that we have a technology does not make it effective for all people, and we actually have very good data regarding where such technology can be effective, and where it is unlikely to be effective. It is time we looked seriously at our own data and stopped performing treatments that we know are ineffective.
This study was also discussed by Maggie Jones on The New Old Age blog last week.
Another study by researchers at Thomas Jefferson University examined the discrepancy between what kind of care patients state they want and what their proxy decision maker believes they want. Researchers interviewed 200 older patients and asked about specific treatment preferences they would want if they had advanced dementia. The results showed that patients would want certain interventions less frequently than their proxys reported.
