Palliative care helps improve quality, cut end of life care costs

Mar 1 2010

The Philadelphia Inquirer reports on palliative care and focuses on a fairly typical American hospital in Abington.

"The end of life is ... when the use and expense of health care soars. Medicare spent an estimated $143 billion in 2009 caring for people in their last year. ... Palliative care took root 10 years ago -- with three catalysts -- said Sean Morrison, director of the National Palliative Care Research Center at Mount Sinai School of Medicine in New York. One was a famous study in medical circles, published in 1996, known as the SUPPORT study, that showed Americans often died in pain, their wishes for how they'd like to end their lives unknown or ignored. The second trigger was Jack Kevorkian. ... The third was millions of dollars in grants, particularly from the Robert Wood Johnson Foundation and George Soros' Open Society Institute, to create and train palliative teams."

"Between 2000 and 2006, palliative care programs more than doubled, from 632 programs to about 1,300. About 53 percent of all hospitals with more than 50 beds have a program. ... The aim of palliative care, Morrison said, is to understand a person's goals and values and match those with the treatment. Once they understand, he said, patients often choose the less aggressive path. He said research had shown that palliative care can dramatically improve patient satisfaction - and, by avoiding unwanted and expensive treatments, save an estimated $6 billion a year" (Vitez, 2/28).

Meanwhile, Kaiser Health News reports on a Catholic directive and end-of-life wishes. "In November, the U.S. Conference of Catholic Bishops approved a revised ethical and religious directive similar to the Tulsa bishop's. It states in part that Catholic health facilities have 'an obligation to provide patients with food and water, including medically assisted nutrition and hydration for those who cannot take food orally.' 'This obligation,' the bishops said, 'extends to patients in chronic and presumably irreversible conditions,' such as persistent vegetative state, who might live for many years if given such care. ... The directive raises fresh questions about the ability of patients to have their end-of-life treatment wishes honored — and whether and how a health care provider should comply with lawful requests not consistent with the provider's religious views" (Meyer, 2/27).