LA hospital illustrates dilemma of expensive end of life care

End-of-life care has become a target for critics who allege many hospitals and physicians order unnecessary and expensive procedures, but it often involves difficult and complex decision-making. The New York Times reports on one hospital with large end-of-life care bills: "The Ronald Reagan U.C.L.A. Medical Center, one of the nation's most highly regarded academic hospitals, has earned a reputation as a place where doctors will go to virtually any length and expense to try to save a patient's life." The center spends significant money "on needless tests and futile procedures" and "is perennially near the top of widely cited data, compiled by researchers at Dartmouth, ranking medical centers that spend the most on end-of-life care but seem to have no better results than hospitals spending much less."

"But the more U.C.L.A.'s doctors study the issue, the more they recognize a difficult truth: It can be hard, sometimes impossible, to know which critically ill patients will benefit and which will not. That distinction tends to get lost in the Dartmouth end-of-life analysis, which considers only the costs of treating patients who have died. Remarkably, it pays no attention to the ones who survive." According to experts at U.C.L.A., efforts to reduce spending may not be effective "unless the distinction can be clearly drawn between excellence and excess in medical care" (Abelson, 12/22).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.