About End-of-life Care
Dying patients are happier, less depressed, have less pain and survive longer when their end-of-life care wishes are known and followed, researchers report. This type of patient-centered care can also help to keep costs down
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patients who don"t want aggressive treatments and those with advanced cancer"s and other diseases that can"t be effectively treated, the University of California, Los Angeles (UCLA) research team said.
"We can improve care while
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costs by making sure that everything we do is centered on what the patient wants and what his or her specific goals are, and then tailoring a treatment plan to ensure we
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the specific care he or she wants," Dr. Jonathan Bergman, a clinical scholar and fellow in the urology department, said in a university news release.
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many cases, dying patients are given aggressive treatments that don"t help them and
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higher costs.
Patients who want
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care should, of course, receive it, Bergman said. But many don"t want such treatments and simply have not been
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about their needs and desires, according to Bergman and colleagues, who are testing patient-centered care
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cancer patients.
To change this situation, doctors need to be educated about patient-centered care, the researchers said. They also
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that changes to Medicare should be considered. But this is a highly controversial topic that has been sidelined after recent suggested changes were characterized as creating "death panels".
"Given the disproportionate cost of care at the very
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of life, the issue should be revisited," Bergman and colleagues wrote. "We should address goals of care, not to
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aggressive care to those who want it, but to ensure that we deliver aggressive care only to those who
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. This reduces costs and improves outcomes."
Medical care during the final stages of life is often poorly coordinated and fails to take into account a patient"s preferences, the UCLA researchers say. It also consumes the lion"s share of health care dollars. A 2004 study found that 30 percent of Medicare resources are
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on the 5 percent of beneficiaries who die each year, and one-third in the final year of life
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during the final month.
Yet research has shown that by instituting patient-centered care, costs in the last week of a patient"s life can be reduced
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36 percent, and death, when it comes, is less likely to occur in an intensive care unit.