Could end-of-life care be getting worse?

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Emily Mongan
Emily Mongan

It's easy to assume end-of-life care in this country is improving. After all, more people than expected began taking advantage of Medicare-covered end-of-life care consultations with their physicians last year. Sign up for any long-term care conference and you're bound to find at least one session on palliative or end-of-life services.

With more providers and patients than ever focusing on palliative and hospice care, shouldn't the quality improve at least a little bit?

Not necessarily, according to a research letter published Monday in JAMA Internal Medicine. The research aimed at studying racial disparities in end-of-life care areas, which past investigations have identified.

Results of the new survey, carried out by researchers at the University of Washington-Seattle, found no significant difference in end-of-life care between white or black Medicare beneficiaries.

The study found some differences — black patients were more likely to die in a hospital, and were less likely to use hospice services in their final month of life — but over all, quality ratings were fairly even between the two groups.

But among both black and white patients, one trend did emerge: less than half of the patient family members who responded to the survey reported that their loved one had received excellent end-of-life care. One-fifth of the respondents also noted that they weren't always kept informed about the patient's care or condition.

The fact that patients' family members rated their loved ones' care only somewhere between good and poor, instead of very good or excellent, “adds to previously reported concerns that the quality of end-of-life care may be worsening for older people in general and suggests that improvements are needed for all patients in the United States,” the study's authors wrote.

As discussions on end-of-life care and advanced directives continue, bear in mind this survey's results and the value of the services you may be providing — before this sector of the healthcare industry suffers from a case of quantity over quality.

Follow Staff Writer Emily Mongan @emmongan.






Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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