Cancer Care for Dying Patients On The Rise
"But right now, the reimbursement system will pay for that, even though retrospectively we would say that care is outside published best practice guidelines and should never have been given."
Among the report's other key points:
Hospital Deaths: Nationally, the percent of cancer patients who died in the hospital decreased more than 4 percentage points, from an average of 28.8% during a period between 2003 and 2007 to 24.7% of patients in 2010. More patients, 54.6% to 61.3% were enrolled in hospice in the last month of life.
ICU Care: The percentage of patients admitted to a hospital ICU during the last month of life went from 23.7% to 28.8% during these two reviewed periods, and the percentage of patients who were placed on hospice during their last three days of life increased from 8.3% to 10.9%, which meant there was less opportunity for meaningful palliative care.
Multiple MDs: The percent of patients treated by 10 or more physicians during their last six months of life went from 46.2% to 58.5%, suggesting more rather than less fragmentation of their care.
Lifesaving measures: The use of treatments such as endotracheal intubation, feeding tube placement, and cardiopulmonary resuscitation during the patients' last month of life remained unchanged. And the average percentage of patients who received chemotherapy in the two weeks before their deaths was unchanged.
Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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