Los Angeles: Weighing Medical Costs of End-of-Life Care

Description:

The Ronald Reagan UCLA Medical Center (UCLA) is a hospital located on the campus of the University of California, Los Angeles. UCLA has a culture of intensive medical treatment of end-of-life patients, and maintains that some are justifiable, and that the high cost reflects excellence, not waste. They point to one kind of patient — heart failure patients — and a study that shows that the hospitals that spend the most on those patients seem to save the most lives.

On the other hand, the researchers behind the Dartmouth end-of-life analysis say their different general conclusion — that higher spending does not necessarily buy better patient outcomes — is backed by decades of research. They say that, while more spending may have yielded benefits among heart failure patients at UCLA, hospitals generally have not shown they deliver better results when they provide more care.

Dr. Elliott S. Fisher, one of the lead investigators at the Dartmouth Atlas Project, says: "Sometimes more medical care is better," he said, "but the question is when."

Links:

To read the full article click on one of these links, both of which go to the same destination. A short link is provided for the convenience of readers. Also, readers may search and browse past advisories on the web (see bottom.)

  • http://tinyurl.com/yl46xhp

  • http://www.nytimes.com/2009/12/23/health/23ucla.html

    Also see:

  • Peter Singer: The burden borne by the living [The Sydney Morning Herald]
    http://www.smh.com.au/opinion/politics/the-burden-borne-by-the-living-20091230-lju5.html

    In a column on health care costs, Peter Singer writes: Here it makes sense to start at the end. Treating dying patients who do not want to go on living is a waste, yet only a few countries allow physicians actively to assist a patient who requests aid in dying. In the US, about 27 per cent of Medicare's budget goes towards care in the last year of life. While some of that is spent in the hope that the patient will have many years to live, it is not unusual for hospitals to provide treatments costing tens of thousands of dollars to patients who have no hope of living more than a week or two - and often under sedation or barely conscious.

  • New York: Hard Choice for a Comfortable Death: Sedation [The New York Times]
    http://www.nytimes.com/2009/12/27/health/27sedation.html

    This is a thorough six page introduction and review on the subject of terminal sedation, which is palliative sedation that renders an imminently dying person unconscious.

    In a small part of this report, Dr. Edward Halbridge, a hospice medical director is interviewed: Young residents often challenge him, saying things like, "If I'm 105 years old, I want to be fed, no matter what." His response is, "O.K., but did you ask your patient what he wants?" Some patients are getting "multi-million-dollar workups" in the intensive care unit, he said, but make their wishes known by pulling out tubes. "I think a light bulb should go off in somebody's head after the third time he pulls it out. Am I going to change the outcome of this, and if I'm not, why am I doing it?"

Source:

Abelson, Reed. "Weighing Medical Costs of End-of-Life Care". New York Times. December 23, 2009. <www.nytimes.com/2009/12/23/health/23ucla.html>. New York Times, The New York Times Company, 620 Eighth Avenue, New York, NY 10018, U.S.A.

Tags:

Tags (or keywords) briefly indicate some major topics of the report.

  • Continuous Deep Sedation (CDS)

  • Dartmouth Atlas of Health Care

  • palliative care

  • California

  • U.S.A.

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ID:

The EuthaNEWSia ID for this advisory is: enid200912302870.
Mailed: Wednesday, December 30, 2009 14:27:44 -0600
at Saskatoon, Saskatchewan.

Etcetera:

EuthaNEWSia is a free Canadian news advisory service covering end-of-life issues such as right to die, assisted suicide, and euthanasia. EuthaNEWSia is produced by the Right to Die Society of Canada which works toward a good death for all, including open, regulated and equitable access to euthanasia and assisted suicide. The editor is Michael Dawson <editor@euthanewsia.ca>. 

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