Advance directives mean more palliative, less costly care, study shows

Individuals with advance directives are more likely to receive palliative care and are less likely to die in a hospital, a new study finds.

Medicare expenditures for enrollees with advance directives also are lower, especially in higher-spending regions of the United States, researchers from the University of Michigan noted. Their study is one of the first to look at national data linking end-of-life spending, treatments and advance directives.

Investigators analyzed records of Health and Retirement Study participants who died between 1998 and 2007, including their Medicare claims. University researchers also conducted interviews with beneficiaries’ next of kin.

The clinical impact of advance directives depends on the context in which a patient receives end-of-life-care, investigators noted, stating that directives made the biggest difference for patients living in regions with higher average levels of spending.

The study was published in the Oct. 5 issue of the Journal of the American Medical Association.