Articles tagged with Hospice Care
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A new study found that expanded hospice care improved indicators of care quality, including reduced reliance on intensive care and feeding tubes. However, it also led to increased costs to Medicare of $6,761 per patient on average due to longer stays and increased provider numbers.
A new study reveals that the perception of quality care for the dying in the US has worsened over the last decade, with loved ones reporting a decrease in satisfaction. Despite efforts to improve end-of-life care, significant gaps remain between patient and provider preferences.
A three-year analysis by Mount Sinai researchers found that early palliative care interventions can improve geriatric emergency care, decreasing hospital lengths-of-stay and costs. The approach is shown to have reduced ICU admissions for patients aged 65 and older by 1.4%.
New research from the University of Missouri shows a significant increase in end-of-life discussions among individuals. The study found that advance care planning is not strongly linked to socioeconomic status or education level, but rather household income plays a role in designating a healthcare proxy.
A Penn study analyzed 277,693 ICU patients with preexisting limits on care, finding that 23% received CPR despite DNR orders. Variability in care was significant, with some ICUs offering life support to nearly all patients and others with minimal use.
A large national survey found that nursing home directors with greater palliative care knowledge experienced less aggressive end-of-life care, including reduced use of feeding tubes and emergency room visits. This association suggests that improving staff knowledge could lead to better care for thousands of residents.
After 40 years of work, experts conclude that securing individual rights, improving caregiving relationships, and reforming healthcare systems are crucial to advancing end-of-life care. Strategies include training clinicians in communication skills, designing systemic improvements, and enacting financing reforms.
A new study has identified eight specific physical signs associated with imminent death in cancer patients, including non-reactive pupils and drooping of the nasolabial fold. These signs can help healthcare professionals make a diagnosis of impending death, allowing for more informed decisions about treatment and care.
A study by MD Anderson researchers identified eight physical and cognitive signs associated with imminent death in cancer patients. These signs include nonreactive pupils, decreased response to verbal and visual stimuli, and upper gastrointestinal bleeding, which could help clinicians communicate with patients and families, as well as ...
A Canadian multicenter survey of over 1,200 hospital-based clinicians identified key barriers to end-of-life care discussions with seriously ill patients and their families. The study found that factors such as difficulty accepting a poor prognosis, limited understanding of life-sustaining treatments, and disagreements among family mem...
Leading cardiac specialists have proposed new guidelines for donor heart allocation to increase patient survival rates. The revised system considers factors such as illness severity, waiting list mortality, and geographic variations in allocations.
Only 2.2% of American physicians have DEA waivers for prescribing buprenorphine-naloxone, a treatment for opioid use disorder, with most practicing in urban counties. This scarcity limits treatment options in rural areas, leaving over 30 million persons without access to this life-saving medication.
Researchers found that nursing home hospice patients have longer stays, are more likely to be women and have dementia, and often receive higher Medicare spending compared to those living in the community. The study also identified a 'crossover' group with significantly longer hospice stays.
A new study published in Annals of Internal Medicine found that breast density notification laws substantially increase costs and save relatively few lives. The study suggests that these laws would result in limited health gains and substantially increased expenses.
A study found that Medicare patients with poor-prognosis cancers who received hospice care had significantly lower rates of hospitalizations, ICU admissions, and invasive procedures at the end of life. Hospice beneficiaries also had lower health care expenditures during the last year of life.
Researchers at Brigham and Women's Hospital found that patients without hospice care had significantly higher rates of health care utilization and costs during their last year of life. Hospice care was associated with lower rates of hospitalizations and intensive procedures.
A new report from The Gerontological Society of America highlights the importance of advance directives in securing appropriate advanced illness care. It presents new models and tools that family members and providers can use to provide person- and family-centered care, which may be cost-effective.
A new study by the American College of Surgeons recommends that older trauma patients receive palliative care to address their physical, emotional, social, and spiritual needs. The study found that elderly trauma patients have unrecognized needs for palliative care, which can improve their quality of life and alleviate pain.
A new collaborative model in cancer care at Duke University Hospital has shown a significant reduction in hospital readmissions and improvements in patient outcomes. The 'co-rounding' format integrates palliative care into daily inpatient care, resulting in decreased intensive care unit transfers and earlier discharges.
A new study published in Journal of Palliative Medicine shows that inpatient palliative care can significantly lower hospitalization costs and the rate of readmissions. By providing expert care to seriously ill patients, hospitals can improve patient outcomes while reducing healthcare expenses.
A study of Medicare data found that hospitals with high care intensity had lower failure-to-rescue rates after major surgery, but longer hospital stays. However, patients treated at these hospitals also experienced higher inpatient deaths and reduced hospice use.
A new Penn Medicine study reveals that certain patient characteristics, such as being male, married, and younger than 65, may be associated with shorter hospice stays. The study also found that patients with blood cancers and Medicaid or uninsured status tend to enroll in hospice earlier in their illness
A study examining Medicare hospice discharges found that nearly 1 in 5 patients were discharged alive, sparking concerns about cost-saving measures. The researchers also discovered significant variation in live discharge rates across states and individual hospices.
Despite limited evidence, antibiotics are still widely prescribed to terminal hospice patients, with 27% continuing use in final week of life. This raises concerns about unnecessary side effects, adverse events, and antibiotic resistance.
The BMJ editorial advocates for the Assisted Dying Bill, citing a strong public consensus of 82% in favor, as well as Oregon's experience with assisted dying legislation. The bill aims to allow terminally ill adults to end their lives with medical assistance.
Researchers pinpointed common perioperative procedures with little clinical evidence, recommending elimination to reduce costs and improve quality of care. The 'Choosing Wisely' campaign supports these findings, encouraging physicians to adopt evidence-based medicine.
A Scripps Whittier study shows that text messages can help improve glycemic control in Latino patients with type 2 diabetes. The intervention used text messages to provide healthy nutrition tips, physical activity reminders, and medication adherence encouragement.
A population-based observational study found centenarians are more likely to die of pneumonia and frailty, while hospital deaths were higher in England compared to other European countries. The study suggests that better health care provision could enable people to remain in their usual residence and reduce hospital admission at the en...
The Liverpool Care Pathway's correct use improves end of life care, despite widespread complaints. The pathway recommends morphine to relieve pain and involve relatives in decision-making, contrary to media reports.
A study found that the quality of death for cancer patients in urban Canadian settings with ready access to palliative care was good to excellent in most cases. Factors such as social support, caregiver relationship length, and home death were linked to better scores on a scale measuring the dying experience.
A recent study by Allina Health found that sharing clinical information with other health systems can avoid duplicative diagnostic procedures, such as blood work and imaging. By using the Care Everywhere tool, providers were able to eliminate 560 potentially duplicative diagnostic procedures.
A new study by Brown University researchers found that hospital attending physicians' specialties are linked to the likelihood of patients receiving gastric feeding tubes, which is not recommended for frail, terminal patients. The study analyzed tens of thousands of cases over a decade and found that patients cared for by primary care ...
A study by Johns Hopkins Bloomberg School of Public Health found that cognitive impairment affects seniors in both nursing homes and the community, with patients lacking advance directives receiving aggressive care. Advance care planning is essential to ensure desired treatments are followed.
A new study from Michigan Medicine and the Veterans Affairs Ann Arbor Healthcare System found that a record 72% of elderly Americans completed living wills in 2010, up from 47% in 2000. Despite this increase, hospitalization rates and deaths in the hospital remained largely unchanged over the decade.
The IMPaCT model, which employs trained lay Community Health Workers (CHWs), has been shown to improve patient experiences and health outcomes. The intervention group had a 52% greater chance of seeing a primary care physician within two weeks after discharge and reported better communication with healthcare providers.
A study found that training hospital staff in basic hospice strategies led to improved end-of-life care, including more orders for pain medication and the removal of nasogastric tubes. The intervention also increased the presence of advance directives, reducing distress for patients and families.
A study of over 4,400 physicians found that those who would personally enroll in hospice care are more likely to discuss it with patients, but delays remain. Despite personal preferences, many physicians do not have timely discussions about end-of-life care with terminally ill cancer patients.
Researchers found a significant reduction in Medicare spending of $721 annually per patient, with no adverse consequences for survival, through the use of accountable care organizations (ACOs). ACOs led to better management of acute care, resulting in fewer hospital admissions among beneficiaries with prevalent cancer.
Palliative care is misunderstood as a synonym for end-of-life care, causing patients to miss out on symptom relief. Early palliative care can improve quality of life and outcomes for patients with serious illnesses.
A University of Colorado Cancer Center study validates the CARING criteria, a prognostic tool determining risk of death within a year of hospital admission. The tool uses five criteria: cancer diagnosis, chronic illness admissions, nursing home residency, ICU admission with multi-organ failure, and hospice guidelines.
A new approach to palliative care has been shown to reduce emergency room visits and improve overall care for high-risk geriatric patients. The customized care model, matched to their changing needs at home, also reduces healthcare costs.
A pilot initiative at Mount Sinai Hospital shows that establishing standardized criteria for calling a palliative care consultation improves the quality of care for patients hospitalized with advanced cancer. This led to increased use of hospice services, lower in-hospital mortality and hospital readmission rates.
A new study reveals an independent association between sleep apnea severity and increased high sensitivity troponin T levels, a marker of early myocardial injury. Higher levels were associated with an increased risk of coronary heart disease and heart failure.
The study found no clinically meaningful differences in overall quality of care between the LCP-I wards and control wards. However, families rated key aspects of care such as respect, dignity, and kindness, showing some improvement in the LCP-I wards.
A new machine learning model accurately flags risk for post-stroke dangers, outperforming traditional transcranial doppler tests in detecting blood vessel constriction. The method combines existing ICU data and is less resource-intensive, but its effectiveness depends on IT infrastructure.
A new study suggests that managed-care residents with advanced dementia are more likely to have a do-not-hospitalize order in place and fewer hospital transfers for acute illness. This research found no appreciable difference in survival outcomes between the managed care and fee-for-service groups.
Researchers found Medicare heart attack expenses increased by 16.5% overall, with significant growth in post-hospital care costs, including skilled nursing facilities and outpatient care. Mortality rates declined from 36% to 31.7% during this period.
The study aims to determine end-of-life needs and available services for HIV/AIDS patients in Appalachian regions. The researchers will examine factors such as poverty, lack of health services, and stigma, and develop targeted interventions to address discrepancies.
A new study reveals a complex system of perspectives among hospice organizations and workers regarding physician-assisted death. Despite being historically opposed, many caregivers now struggle to balance their core beliefs with the new laws, leading to varied reactions and approaches.
Researchers will assess the effectiveness of palliative care home health visits in treating people with HIV and other chronic illnesses. The four-year study aims to improve quality of life and outcomes for patients with HIV, focusing on symptom management, coping, and advance care planning.
A UK study reveals that despite national recommendation, only 47.4% of terminally ill patients are placed on the Liverpool Care Pathway for end-of-life care. Lack of knowledge and staff support may be contributing factors to its underutilization.
The university has received a five-year, $1.76 million grant from the National Institute of Nursing Research for a pre- and postdoctoral fellowship program in palliative care. The goal is to train nurse scientists to advance knowledge on effective palliation for patients with advanced diseases.
A study found significant variation in ICU patients' decisions to forgo life-sustaining therapies among US hospitals, with factors like hospital culture and physician practices playing a major role. Patient characteristics such as age, race, and functional status also influence these decisions.
A study found that high spiritual support from religious communities is associated with reduced aggressive treatment in patients with advanced cancer. Patients receiving spiritual support from the medical team had higher rates of hospice use, fewer aggressive treatments, and fewer ICU deaths.
Researchers identified five trajectories for patients with end-stage heart failure, providing a framework to predict the path to death and improve quality of life. The study's findings can help caregivers plan for the last months of life, enabling patients to gain control over their illness.
By 2030, heart failure costs are projected to exceed $70 billion, with 8 million people affected, up from 5 million in 2012. Improved prevention and treatment strategies are needed to address this growing burden.
A study found that racial disparities in end-of-life care among US adults with kidney failure are substantial and vary by region. Black patients are less likely to discontinue dialysis and be referred to hospice compared to white patients, especially in high-end life spending regions.
A study found significant racial disparities in end-of-life care among US adults with kidney failure, with black patients less likely to be referred to hospice and discontinue dialysis compared to white patients. The differences were most pronounced in regions with the highest levels of end-of-life spending.
The study found that while the program was rarely used, those who participated reported gratitude for receiving a lethal prescription, regardless of use. The most common reasons for participation included loss of autonomy, inability to engage in enjoyable activities, and loss of dignity. SCCA's approach prioritizes palliative care and ...
A UK study published in PLOS Medicine found that hospital deaths decreased by half between 2005 and 2010, while home and hospice deaths increased. The study attributed this shift to improved end-of-life care initiatives, particularly for single people, the elderly, and those with certain cancer types.