NewsLine - June 2012 - (Page 29)

New Study Finds Intensity of EOL Care High for Medicare Beneficiaries With Cancer A new study by Dartmouth researchers examined the intensity of health care delivered to Medicare enrollees who were terminally ill with cancer, and found that the overall intensity of care was high—probably far more so than many patients would prefer. What’s more, the nation’s most elite cancer care centers performed only modestly better than community hospitals at meeting recognized quality standards for treating these dying cancer patients, displaying similar patterns of relatively aggressive, high-intensity treatments in the final weeks of life. More than a twofold variation was observed within hospital groups with common features, such as cancer center designation and for-profit status, but these hospital characteristics explained little of the variation in intensity of care and none reliably predicted a specific pattern of care. The researchers also found that even among hospitals with a specific clinical focus on cancer care, such as those in the National Comprehensive Cancer Network and at designated National Cancer Institute centers, there were significant variations in how they treated patients at the end of life. The analysis found twofold differences among these institutions in the rates of intensive care unit use in the last month of life, chemotherapy in the last 14 days of life, deaths occurring in the hospital—and the use of hospice care for fewer than three days. The analysis included more than 215,000 Medicare patients with poor-prognosis cancer (meaning that they were likely to die within a year) and the care provided to them at approximately 4,400 hospitals nationwide from 2003 through 2007. For each patient, researchers studied the care received in the six months preceding their death, such as hospitalizations, hospice use, intensive care unit use and the number of physicians providing care. The study (“End-of-Life Care for Medicare Beneficiaries With Cancer is Highly Intensive Overall And Varies Widely”) was published in the April 2012 edition of Health Affairs. The lead author is Dr. Nancy Morden, a researcher at the Dartmouth Institute for Health Policy and Clinical Practice, assistant professor at the Dartmouth Medical School, and investigator in the Cancer Control Research Program at the DartmouthHitchcock Norris Cotton Cancer Center. Even among hospitals with a clinical focus on cancer, there were significant variations on how they treated patients at the end of life. Short Takes continued on next page NewsLine 29 http://content.healthaffairs.org/content/31/4/786.abstract

Table of Contents for the Digital Edition of NewsLine - June 2012

A Plan to Support ADRs
A Message From Don
Task Force Focuses on Rural Issues
Join the Rural eGroup
Rural and Frontier Area Toolkit (display ad)
Palliative Services at Methodist Healthcare
Experience the ACHC Difference (display ad)
The Voice of NCHPP
Empowering Hospice Aides
My.NHPCO—a Great Resource for Hospice Nurses
HPCANYS Receives Trailblazer Award
New EOL Study on Intensity of Cancer Care
Run to Remember Proceeds Now Support African Hospices
EROM Now POM
Simione: Solving Your Hospice Challenges (display ad)
Staying Savvy and Saving Money
Regulatory Tip of the Month
MLC Plenaries Now Webcasts
Resource Links to Bookmark
Videos Worth Watching
News From NHF

NewsLine - June 2012