Hospice care falls as more Americans spend final days in hospitals; Milwaukee hospital reports success with treatment guidelines

The Associated Press: "Americans increasingly are treated to death, spending more time in hospitals in their final days, trying last-ditch treatments that often buy only weeks of time, and racking up bills that have made medical care a leading cause of bankruptcies. More than 80 percent of people who die in the United States have a long, progressive illness such as cancer, heart failure or Alzheimer's disease." More than 80 percent of them express an intent to "avoid hospitalization and intensive care when they are dying, according to the Dartmouth Atlas Project, which tracks health care trends. Yet the numbers show that's not what is happening: The average time spent in hospice and palliative care, which stresses comfort and quality of life once an illness is incurable, is falling because people are starting it too late" (Marchione, 6/28).

Milwaukee Journal Sentinel: Meanwhile, after implementing new treatment guidelines, Froedtert Hospital, the medical center for the Medical College of Wisconsin, "reduced the average length of stay for patients hospitalized for reasons other than surgery, such as those with pneumonia or heart failure, by a full day, or about 16%. Patients are recovering faster -- and the hospital and health plans are saving money." The effort "to implement guidelines is part of a gradual revolution that has been taking hold in medicine over the past 25 years, the move toward so-called evidence-based medicine. The goal is to bring more standardization -- and, to a degree, order -- to medicine and health care by helping to ensure that doctors are drawing on the best current evidence when treating patients." Yet despite the successes, such guidelines raise questions about whether it is producing cookbook medicine and interfering with the doctor-patient relationship (Boulton, 6/27).

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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.