For example, while both Allegheny General Hospital in Pittsburgh and Georgetown University Hospital in Washington, D.C. had similar percentages (38%) of patients who died of their cancers while hospitalized, not a desirable goal, "by 2010, rates moved in opposite directions.
Georgetown joined a group of medical centers with the highest rates of death in the hospital, 42%, (while) the rate at Allegheny General Hospital dropped to about 17%," Goodman said.
Likewise, at Northshore University HealthSystem's Evanston Hospital outside Chicago in 2010, 10% of cancer patients who died had chemotherapy in the last two weeks of life in 2010, which was a steep increase from 4% in the 2003-2007 period studied.
To illustrate that this is not just a practice in suburban Chicago, Goodman added that Advocate Lutheran General Hospital in nearby Park Ridge saw chemotherapy use in the last two weeks drop, from 10% to 6%.
The issue is of critical importance because more than 500,000 people in the United States die each year from cancer, at great cost to the healthcare system.
Ira Byock, MD, director of palliative medicine at Dartmouth-Hitchcock Medical Center, blamed the trend in part on the fee-for-service reimbursement system, "which is procedure-based and treatment-based, and is permissive of the trends we're seeing."