ElderBranch Explores the Current State of End-of-Life Care in the U.S.

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Care at the end of life is often inadequate and costly, resulting in significant negative implications for the elderly, their family members as well as the health care system at large. However current research supports the notion that end-of-life care can achieve cost savings while improving patient outcomes and care.

ElderBranch today released the first in a four-part series on end-of-life care – End-of-Life-Care I: Where We Are Today. Part one examines the current state of end-of-life care and some of the latest research on the topic.

The costs associated with end-of-life care are very high, with the Centers for Medicare & Medicaid Services reporting that 28% of Medicare costs are attributable to patients in their last year of life. Unnecessary emergency department visits and hospitalizations are a major contributing factor to these costs as acute care (care in a hospital setting) episodes average around $16,000 each.         

At the same time, while costs are high, the quality of care is often lacking. Many spend their last days going in and out of the hospital and, unfortunately, often die there. Furthermore, not enough people take advantage of available hospice programs which are designed to provide comprehensive, quality comfort care to those with less than six months to live.

Fortunately, research based on pilots in palliative care is showing that it is possible to bring down costs while providing better care when it comes to end of life treatment. Palliative care is similar to hospice, but it does not preclude one from receiving curative care and is available at any stage of a disease.

In 2010, The New England Journal of Medicine published a study, “Early Palliative Care for Patients with Metastatic Non-Small-Cell Lung Cancer”, looking at the impact of providing palliative care to a specific patient population soon after their diagnosis. The results showed that among the patients who lived through the study period, those who were given access to early palliative care demonstrated an improved quality of life, had fewer depressive symptoms and survived longer despite fewer receiving aggressive care.

Another study published in The Journal of the American Geriatrics Society in 2007, “Increased Satisfaction with Care and Lower Costs: Results of a Randomized Trial of In-Home Palliative Care”, discusses the issue from two angles: cost and quality. Those enrolled in the palliative care program experienced fewer hospital days and emergency department visits, were more likely to die at home instead of at the hospital and the average cost of care per day for these patients was significantly lower.

In next part of the series, ElderBranch will explore three innovative models of end-of-life care that are being trialed across the United States.

About ElderBranch
ElderBranch is an online information portal that helps people find and evaluate long-term care providers. ElderBranch’s mission is to support users in making the best decision possible for themselves and their loved ones. ElderBranch currently offers a comprehensive, national database of nursing homes and useful articles and tools to help users navigate senior care issues and decisions.

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Anila Sitaram Venkat
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