Researchers from the University of Pennsylvania School of Medicine propose recrafting federal anti-kickback laws to allow more sensible health-promoting initiatives. The authors suggest laws should distinguish between inducements for high-value services with medical benefits and those that mainly benefit provider profit margins.
A new study led by researchers at Mount Sinai Hospital found that early referrals to palliative care reduced healthcare utilization and increased use of support services after discharge. The study also showed significant improvements in 30-day readmission rates, hospice referral, and chemotherapy receipt.
Oregon's end-of-life care approach is characterized by higher rates of home hospice use and fewer hospitalizations, while Washington lags behind in implementing similar initiatives. The state's POLST Program has been instrumental in honoring patients' wishes and improving symptom management.
A long-term study found that e-cigarette users who stopped smoking cigarettes substantially reduced their intake of cancer-causing chemicals compared to those who continued to smoke. The study confirms that e-cigarettes are much safer than conventional cigarettes and may be a useful long-term quitting aid for patients.
A new study by The Dartmouth Institute finds that Accountable Care Organizations (ACOs) with a high proportion of minority patients tend to perform worse on quality-of-care measures. ACOs serving these populations often struggle to offer essential services like routine specialty care and palliative care.
The Winter 2016 issue features three original research articles, two review articles, a commentary article, a narrative analysis article, and two China Focus articles addressing sociocultural challenges in engaging black sub-Saharan African communities in HIV prevention programs. Other articles discuss the relationship between mothers'...
Greater primary care physician involvement at the end of life is associated with less costly and less intensive care. Regions with more primary care involvement have lower Medicare spending in the last two years of life and fewer ICU days in the last six months.
The National Commission on Prevention Priorities releases updated rankings of clinical preventive services, identifying high-impact services for improving population health. The top three services are immunizing children, tobacco-use screening and brief intervention, and alcohol misuse screening with brief intervention.
A study found that patients with kidney failure were less likely to have advance directives than those with other serious illnesses, but those who did had better end-of-life care. The presence of treatment-limiting directives and surrogate decision makers reduced hospitalizations, intensive procedures, and inpatient deaths.
A routine blood test can predict how long cancer patients in palliative care will survive, researchers report. The Six Adaptable Prognostic models use three laboratory measurements to estimate death within 1-6 months, allowing physicians to re-evaluate prognosis at any time point.
A systematic review and meta-analysis found that palliative care was associated with improvements in patient quality of life, symptom burden, and advance care planning. The findings suggest that palliative care can have a positive impact on patients' lives, but more research is needed to identify the most effective interventions.
Researchers found that palliative care treatment reduced hospital admissions and difficult transitions for older adults with serious illnesses in nursing homes. Palliative care consultations earlier in the illness also improved outcomes.
Research by Allina Health LifeCourse reveals that late-life quality of life improves socially but remains emotionally stable, with caregivers playing a crucial role. The study also identifies the need for training and support for family members in caregiving roles.
Researchers at Allina Health present findings from the LifeCourse study, which shows that a whole-person approach to care can reduce health care utilization in late-life. The study found that patients who received care from lay health workers experienced improved quality of life and resilience in the face of decline.
A home-based palliative care (HBPC) program for individuals with advanced illnesses was associated with significant cost savings and improved quality of care. The study found a mean total cost of care per person reduced by $12,000, fewer hospital admissions, and greater use of hospice during the final three months of life.
A study of 34,444 patients found that 21.9% had ambulatory care-sensitive conditions, with 52% having cardiovascular disease. In-patient mortality rates were significantly lower for those with cardiovascular ACSCs compared to non-cardiovascular.
A new Belgian study shows an increase in euthanasia cases since legalization, with notable rises among people with non-cancer diagnoses and those over 80. Thorough evaluation and monitoring are crucial in these complex situations.
A new study by Michigan Medicine found that African Americans and Hispanics have higher Medicare costs for end-of-life care, despite controlling for individual factors. The researchers conclude that disparities are rooted in the healthcare system as a whole.
Vincent Mor, PhD, of Brown University, received the 2016 Robert W. Kleemeier Award for his outstanding research on aging and care quality. He has conducted extensive work on hospice and palliative care, including a study on National Hospice Study's effect on patients' quality of life.
A global analysis of 38 studies found that over a third of elderly patients receive invasive and potentially harmful medical treatments at the end of their life. The study highlights the need for better training for hospital doctors and more community education to reduce non-beneficial treatments.
Researchers found that non-fit messaging can reduce certain biases in patient decision-making, leading to more thoughtful and informed choices. The intervention strategy is based on motivational theory and has shown promise in improving patient outcomes.
Allina Health's LifeCourse approach demonstrates significantly better quality of life scores for patients with chronic illness compared to usual care. The program employs a patient-centered experience tool to understand and support the needs of complex patients.
A new study analyzing Medicare data identifies four patterns of end-of-life spending, revealing that nearly half of older Americans' high spending was already in motion a year before death. The 'High Persistent' group had the highest spending, while the 'Late Rise' group had very low spending until their final months.
Researchers found that patients who were asked about their preferred site of death and those in hospices with frequent symptom monitoring had lower hospitalization rates. For-profit hospices, however, showed persistently high hospitalization rates regardless of practice implementation.
A study found that nearly two-thirds of younger cancer patients with metastatic disease received hospitalization, emergency room visits, or chemotherapy in their last 30 days. Researchers call for earlier discussions on palliative care to improve quality of life.
Researchers found that Medicare Advantage patients are younger, healthier, and more likely to be black and live in cities than those enrolled in traditional Medicare. They also reported better health outcomes and fewer problems performing daily life activities on their own.
A study by University of Houston Graduate College of Social Work researchers examines the perceptions and preferences of older Latinos with advanced cancer regarding news on their diagnosis or prognosis. The investigation aims to identify culturally appropriate training for physicians and providers, promoting quality end-of-life care.
A study published in Journal of the American Geriatrics Society found that doctors and non-doctors in the US experience similar levels of hospital care and intensive care unit stays at the end of life. More than 46% of doctors enrolled in hospice care compared to 43.2% of non-doctors, suggesting a shift towards more palliative care.
A study found that only 52% of cancer patients received palliative care as recommended, highlighting the need for improvement in end-of-life care. Hospice care was more accessible to veterans than non-veterans, but disparities persisted.
A pilot program using video decision aids increased the documented incidence of advance care planning conversations and hospice discharges in Hilo, Hawaii. The program improved end-of-life care by allowing doctors to have critical conversations with patients about their individual preferences.
Physicians use more hospice care, spend more time in Intensive Care Units (ICUs) and just as much time in hospitals compared to the rest of the population. Doctors used an average of 2.4 days longer in hospice care at the end of life.
Research reveals US physicians utilize hospice and intensive care more frequently than non-physicians at the end of life, contradicting common assumptions. This finding raises concerns about a larger systems issue contributing to high utilization rates.
Researchers found that hospice services don't lead to higher care costs for long-stay nursing home residents, despite concerns about cost shifting. Instead, avoidance of costly hospitalization and post-acute care offsets hospice costs.
A new perspective paper advocates for a comprehensive approach to recognize and manage therapeutic illusion to improve the use of medical treatments. Physicians' unjustified beliefs in treatment can perpetuate unnecessary and costly care.
A large study from Japan found that cancer patients who died at home tended to live longer than those who died in hospitals. The study suggests that oncologists should not hesitate to refer patients for home-based palliative care. Home death may have a positive influence on survival, contrary to previous concerns.
A new editorial emphasizes the need for proper pain assessment and opioid prescribing to balance treatment effectiveness with addiction risks. Experts call for physicians to speak out as a voice of reason in their communities, advocating for safe and effective pain relief when medically indicated.
Studies reveal that up to 31 percent of people with ICDs receive shocks in their last day of life due to lack of deactivation. Researchers stress the importance of informing patients about the benefits of deactivating ICDs when death is near, highlighting communication gaps and cultural challenges around end-of-life planning.
A study found that hospice patients experience multiple care transitions near the end of life, with more than half going to hospitals. These transitions are often associated with younger or non-white patients, those with multiple chronic conditions, or in-patient hospice care. The number of transitions varies widely by state.
A new model examines the relationship between factors impacting African Americans' advance care planning, revealing limited knowledge on improving this population's care. The study highlights the need for personalized approach to end-of-life care and encourages increased awareness.
Hospice programs vary significantly in their visitation rates for Medicare patients nearing death, with black patients and those in nursing homes receiving fewer visits. Analysis of Medicare claims data reveals that hospices with smaller patient volumes and those based in nursing homes were less likely to provide visits.
A University of Missouri researcher found only 10 clinical trials conducted in U.S. hospices since 1985, highlighting a need for more evidence-based care.
The American Diabetes Association has issued a statement offering practical guidelines for managing type 2 diabetes in older adults in long-term care facilities. The recommendations focus on individualized goals, liberal diet plans, and avoiding sliding scale insulin to balance glycemic control while minimizing hypoglycemia risk.
Two studies found that physicians receive less intense end-of-life treatments and are less likely to die in a hospital than the general population. Physicians were also more likely to prefer dying at home and had a different location of death compared to other healthcare professionals and the general population.
A study by Dana-Farber Cancer Institute researchers found that factors such as hospice care duration, ICU admissions, and death location are associated with excellent end-of-life care. Expanding hospice access and revising Medicare provisions could improve quality of life for terminally ill patients.
A study of end-of-life care practices in seven developed countries reveals that the US performs poorly in terms of high-tech interventions and hospital utilization. The US has the lowest proportion of deaths in the hospital, but still admits over 40% of cancer patients to the ICU in their last 6 months of life.
A study found that family members perceive better end-of-life care for patients who received hospice care for longer periods, avoided intensive care unit admissions, and died outside the hospital. These findings suggest that multifaceted approaches can improve preference-sensitive care and overall quality of end-of-life care.
A randomized clinical trial found that ED-initiated palliative care consultations improved quality-of-life scores and median survival without shortening survival. The study suggests that ED visits can provide a unique opportunity for improved access to palliative care.
A majority of hematologic oncologists report that end-of-life discussions happen too late, with most discussions occurring when death was clearly imminent. The delay may be attributed to the curative potential of many advanced hematologic cancers, leading to a lack of clear distinction between curative and palliative care phases.
A new study reveals that ethnic minority populations face significant barriers to receiving quality end-of-life care, with financial resources and insurance being the biggest obstacle. The researchers emphasize the need for education, training, and support to improve end-of-life care among diverse patient populations.
A systematic review of 61 studies found that when missing preferences are included, the majority of those questioned preferred to die at home. However, the large amount of missing data makes it unclear whether home is where most participants with cancer or other conditions preferred to die.
The program aims to support a culture of experimentation, where insights can be turned into data quickly. Eight new projects will develop, test, and implement novel approaches to health care, focusing on topics such as lab monitoring, advance directives, and managing superutilizers.
Researchers found that video conferencing can facilitate shared decision-making among terminally ill patients and family caregivers in hospice care. The study highlights the need for more research on shared decision-making in hospice care to improve patient-centered care.
Despite rapid expansion of palliative care programs in US hospitals, access remains uneven, with smaller hospitals and for-profit institutions being less likely to offer services. Variables associated with a greater likelihood of providing palliative care include presence of a residency training program and links to a medical school.
Researchers from the University of Miami propose a 'diagonal approach' to manage health care, focusing on integrating services across the life span of a person. The approach suggests a need for legislation, access to cost-effective services, financial protection, and integration of services.
The Harvard Review of Psychiatry presents a timely update on new trends and developments in geriatric psychiatry. The special issue discusses policy changes, new diagnostic classifications, and research driving change in mental health care for older adults.
A study from University of Pennsylvania School of Medicine finds that Medicare patients with multiple observation stays face financial liability, with cumulative out-of-pocket costs exceeding the deductible for an inpatient hospital admission for over a quarter of beneficiaries
A recent study by Allina Health found that inpatient palliative care visits improved quality of life and symptom burden for heart failure patients. The research identified key actions taken by PC providers to create positive outcomes among study patients.
A recent study published in Journal of Palliative Medicine found variations in hospice use patterns between states, highlighting the need for improved end-of-life care. Researchers identified differences in the timing and duration of hospice enrollment, which could mask issues requiring attention.
A new study provides a glimpse into the complex dynamics of end-of-life care and emergency response. Paramedics and EMTs often enter situations where a patient's end-of-life wishes contradict their professional code, requiring careful assessment and management to uphold those wishes.
A recent study found that while advance care planning has increased among cancer patients, it hasn't led to a decrease in aggressive medical care received in the last weeks of life. In fact, nearly 40% of respondents reported that their loved ones didn't discuss end-of-life care preferences with them.