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End-of-Life Care More Costly in U.S., but Hospital Stays Lower


  06:13:00 pm, by MedBen5   , 335 words,  
Categories: News, Wellness, Cancer, Hospitals

End-of-Life Care More Costly in U.S., but Hospital Stays Lower

hospital bed

A new study of end-of-life practices in the United States and other industrialized nations suggests that while American doctors are more aggressive in their treatment of terminally ill cancer patients, most patients do spend their final days in places other than hospitals.

According the online site Stat, an analysis of health records from 2010 to 2012 of more than 389,000 cancer patients in the United States, Canada, Belgium, the Netherlands, England, Germany, and Norway over the last six months of their lives found that American cancer patients were more than twice as likely than those in other countries to end up in the intensive care unit, and American patients were more likely to receive chemotherapy.

“We’re still overusing the high-tech aspects of medical care,” said Dr. Ezekiel J. Emanuel, chairman of the department of medical ethics and health policy at the University of Pennsylvania and the study’s senior author. “The ICU, the chemotherapy, it seems like we can’t fully control ourselves when it comes to those high-tech elements.”

The United States spent at least $18,500 per patient in their final months, roughly the same amount spent by Canada and Norway, but about twice as much as England.

The finding that American cancer patients are the least likely to pass away in a hospital (only 22% compared to Canada's 52%) comes as something of a surprise, going against long-held conceits. But as more terminally ill patients express a wish to die at home, the U.S. health system is becoming more responsive to such requests.

The study does comes with several large caveats, however. While all individuals in the study were cancer patients, some ultimately died from other diseases. Also, unlike the other countries analyzed, the U.S. doesn't include physician costs in its hospital cost data -- a discrepancy that could add another 11.5% to total expenditures, potentially bringing U.S. costs to at or near the highest in the study. As such, Emanuel said he considers the study “hypothesis-generating and not definitive.”

Emanuel has also co-written a New York Times op-ed piece about the study.

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