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With Rise in Hospice Use Comes Futile Treatments for Terminally Ill Patients

Update Date: Feb 06, 2013 08:28 AM EST

It is the decision of a terminally ill patient to choose hospice care or family during his/her last days. While the demands for hospice care are increasing, so are the futile treatments which these patients get subjected to, a study finds.

The study was led by Dr. Joan Teno, a palliative care physician and professor of health services policy and practice at the Brown University. It was published in the Journal of the American Medical Association.

For patients who opt for hospice care when suffering from terminal illness, it might be more of a bane than a boon. The study reveals that these patients are subjected to intense and often unnecessary medical procedures.

In the year 2000, 22 percent patients died in hospice care, with the numbers increasing to 42 percent in 2009. Though the amount of Medicare patient deaths while in hospice care has increased by 20 percent in the recent years, the data also shows that many of these patients were unnecessarily subjected to treatments which could not delay their eventual death.

The patients who were observed were all suffering from many terminal diseases like cancer, dementia or chronic obstructive pulmonary disease. They were admitted numerous times in hospitals and had to endure endless procedures before they could finally be recommended for hospice care.

Between the years 2000 and 2009, the amount of terminally ill patients' ICU deaths increased by five patients from 24 to 29 percent, while those on ventilator had 8 percent deaths in 2000 which increased by 1 percent in 2009.

"For many patients, hospice is an 'add-on' to a very aggressive pattern of care during the last days of life. I suspect this is not what patients want. With this pattern of going from the ICU to hospice, these dying patients are getting symptom control layout and can't benefit as much from the psychosocial supports available where there a longer hospice stay," Dr. Teno said in a university news release.

"We need to transform our health care system, from one based on fee-for service medicine for the majority of Americans, to one where people are not paid for just one more ICU day. Instead we need a system where doctors and hospitals are paid for delivering high-quality, patient-centered care that understands the dying patient's needs and expectations and develops a care plan that honors them. We need publicly reported quality measures that hold institutions accountable to the standard of patient-centered care for the dying," Dr. Teno added.

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