profession
Study details care of dementia patients near death
NEWS IN BRIEF — Posted Oct. 10, 2011
About one in five nursing home patients with dementia is unnecessarily hospitalized or transferred in the last days of life, according to a study of nearly half a million Medicare patients published Sept. 29 in The New England Journal of Medicine (link).
Nearly 20% of these patients experienced multiple hospitalizations in the last three months of their lives, were transferred to a different nursing home after hospitalization or were transferred in the three days before they died. The patients who saw the most transfers at the end of their lives were much likelier to be tube-fed, spend time in an intensive care unit, have a serious bedsore or enroll late in hospice. The study authors said that much of this high-intensity care at the end of life is unneeded, but is encouraged by financial incentives. For patients on Medicaid, nursing homes can get paid three to four times more for providing postacute care under Medicare Part A, said an accompanying NEJM editorial (link).
Note: This item originally appeared at http://www.ama-assn.org/amednews/2011/10/10/prbf1010.htm.
