Health care costs in the last week of life associations with End-of-life conversations

Archives of Internal Medicine

Volumn 169, Issue 5, 2009, Pages 480-488

  Zhang, Baohui ^a   Wright, Alexi A ^b   Huskamp, Haiden A ^d   Nilsson, Matthew E ^a   Maciejewski, Matthew L ^g,h   Earle, Craig C ^b,c   Block, Susan D ^a,e,f   Maciejewski, Paul K ⁱ   Prigerson, Holly G ^a,d,e,f  

^a Center for Psychooncology and Palliative Care Research   (United States)

^b Departments of Medical Oncology

^c Population Sciences ^*

^d DANA FARBER CANCER INSTITUTE   (United States)

^e Center for Palliative Care   (United States)

^f BRIGHAM AND WOMEN S HOSPITAL   (United States)

^g DURHAM VA MEDICAL CENTER   (United States)

^h University of North Carolina   (United States)

ⁱ YALE UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ADVANCED CANCER; ARTICLE; ARTIFICIAL VENTILATION; CONTROLLED STUDY; COST MINIMIZATION ANALYSIS; DOCTOR PATIENT RELATION; FEMALE; HEALTH CARE COST; HEALTH CARE UTILIZATION; HEALTH INSURANCE; HOSPICE CARE; HOSPITALIZATION; HUMAN; INTENSIVE CARE; INTERVIEW; LIFE SUSTAINING TREATMENT; MAJOR CLINICAL STUDY; MALE; MEDICAL DECISION MAKING; PATIENT CARE; PRIORITY JOURNAL; QUALITY OF LIFE; RESUSCITATION; SCORING SYSTEM; TERMINAL DISEASE;

ADULT; AGED; ATTITUDE TO DEATH; FEMALE; HEALTH CARE COSTS; HUMANS; MALE; MIDDLE AGED; NEOPLASMS; PHYSICIAN-PATIENT RELATIONS; QUALITY OF LIFE; TERMINAL CARE;

EID: 62449339299     PISSN: 00039926     EISSN: 15383679     Source Type: Journal    
DOI: 10.1001/archinternmed.2008.587     Document Type: Article

References (28)

1. Centers for Medicare and Medicaid Services. 2006 National Health Care Expenditures Data . Baltimore, MD: Office of the Actuary, National Health Statistics Group.January 2008.
2. Barnato AE, McClellan MB, Kagay CR, Garber AM. Trends in inpatient treatment intensity among Medicare beneficiaries at the end of life. Health Serv Res. 2004: 39(2):383-375.
3. Emanuel EJ, Ash A, Yu W, et al. Managed care, hospice use, site of death, and medical expenditures in the last year of life. Arch intern Med. 2002; 162(15):1722-1728.
4. Yu W. End of life care: medical treatments and costs by age, race, and region. Health Services Research and Development study IIR 02-189. http://www.hsrd.research.va.gov/research/abstracts/IIR-02-189.htm. Accessed November 10, 2008.
5. Wright AA, Zhang B, Ray A, et al. Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. JAMA. 2008:300(14):1665-1673.
6. Singer PA. Lowy FH. Rationing, patient preferences and cost of care at the end of life. Arch Intern Med . 1992;152(3):478-480.
7. Schneiderman LJ, Kronick R, Kaplan RM. Anderson JP, Langer RD. Effects of offering advance directives on medical treatments and costs. Ann Intern Med. 1992;117(7):599-606.
8. Teno J, Lynn J, Phillips R, etal: SUPPORT Investigators. Do advance directives save resources [abstract] ? Clin Res. 1993:41 (2):551 A.
9. Karnofsky D, Abelmann W, Graver L, Burchenal J. The use of nitrogen mustard in the palliative treatment of cancer. Cancer. 1948;1:634-656.
10. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373-383.
11. Cohen SR. Mount BM, Bruera E, Provost M, Rowe J, Tong K. Validity of the McGill Quality of Life Questionnaire in the palliative care setting: a multi-centre Canadian study demonstrating the importance of the existential domain. Palliat Med. 1997;11(1):3-20.
12. Agency for Healthcare Research and Quality Website. Welcome to HCUPnet (Healthcare Cost and Utilization Project), http://hcupnet.ahrq.gov/. Accessed November 10, 2008.
13. Hospice Association of America Web site. Hospice facts & statistics. February 2007. http://www.nahc.org/facts/hospicefx07.pdf. Accessed November 10, 2008. Original citation is from Centers for Medicare and Medicaid Services, Office of the Actuary, Center for Health Plans and Providers (November 2006).
14. Bureau of Economic Analysis Web site. National economic accounts. http://www .bea.gov/national/index.htm#gdp. Accessed January 31, 2008.
15. Rosenbaum PR. Rubin DB. The central role of the propensity score in observational studies for causal effects. Biometrika. 1983:70:41-55.
16. Parsons LS. Reducing bias in a propensity score matched-pair sample using greedy matching techniques. http://www2.sas.com/proceedings/sugi26/p214-26.pdf. Accessed July 15, 2006.
17. Drake C, Fisher L. Prognostic models and the propensity score. Int J Epidemiol. 1995;24(1):183-187.
18. Blough DK, Ramsey SD. Using generalized linear models to assess medical care costs. Health Sen Outcomes Res Methodol. 2000:1 (2):185-202.
19. Silverman GK. Temel J, Podgurski LM, et al. Do aggressive treatments in the last week of life harm quality of death? Paper presented at: American Geriatrics Society 2007 Annual Scientific Meeting; May 3, 2007; Seattle, WA.
20. Earle CC, Neville BA, Landrum MB, Ayanian JZ, Block SD, Weeks JC. Trends in the aggressiveness of cancer care near the end of life. J Clin Oncol. 2004;22 (2):315-321.
21. Angus DC, Barnato AE, Linde-Zwirble WT, et al: Robert Wood Johnson Foundation ICU End-Of-Life Peer Group. Use of intensive care at the end of life in the United States: an epidemiologic study. Crit Care Med. 2004;32(3):638-643.
22. Dartmouth Atlas of Health Care. Data tables, http://cecsweb.dartmouth.edu /atlas08/datatools/datatb-s1.php. Accessed November 10. 2008.
23. Sharma G, Freeman J, Zhang D, Goodwin JS. Trends in end-of-life ICU use among older adults with advanced lung cancer. Chest. 2008;133(1):72-78.
24. Dasta JF. McLaughlin TP, Mody SH, Piech CT. Daily cost of an intensive care unit day: the contribution of mechanical ventilation. Crit Care Med. 2005;33 (6):1266-1271.
25. Miniño AM. Heron MP, Smith BL. Deaths: preliminary data for 2004. Natl Vital Stat Rep. 2006;54(19):1-49.
26. Levinsky NG, Yu W, Ash A, et al. Influence of age on Medicare expenditures and medical care in the last year of life. JAMA. 2001;286(11)1349-1355.
27. Barnato AE, Herndon MB, Anthony DL, et al. Are regional variations in end-of- life care intensity explained by patient preferences? Med Care. 2007;45(5): 386-393.
28. Fries JF, Koop CE, Beadle CE, et al. Reducing health care costs by reducing the need and demand for medical services. N Engl J Med. 1993;329(5):321-325.