![]() ![]() Hospice enrollment has been shown to be highly dependent on the type of doctor that you see. Most people enroll in hospice fewer than 20 days before death, despite a Medicare benefit that allows patients to stay for up to six months. Hospice, which for 35 years has provided team-based care, usually at home, to those nearing the end of life and remains enormously successful and popular, is underutilized. Yet we found that they score quite differently on several key quality metrics at the end of life.Ī variety of factors probably contribute to our findings. Petersburg, Fla., are only 45 miles apart and have similar ethnic demographics. ![]() More research is needed to explore these differences and to close these gaps and demand high-quality, personalized care for people of all races.īut race and demographics don’t provide all the answers. One systematic review of more than 20 studies showed that African American and Hispanic individuals utilize advance-care planning and hospice far less than whites. Race and other demographics in a given area certainly matter. (Tabitha Rhea Photography) /Tabitha Liddiard/Tabitha Rhea Photography) ![]() For example, why do 71 percent of those who die in Ogden, Utah, receive hospice care, while only 31 percent do in Manhattan? Why is the rate of deaths in intensive care units in Cedar Rapids, Iowa, almost four times that of Los Angeles? Why do only 12 percent of individuals in Sun City, Ariz., die in a hospital, while 30 percent do in McAllen, Texas?Īndrew MacPherson of the National Partnership for Hospice Innovation. It turns out not all areas are created equal. But we can also rank areas based on how they treat us at an important moment of life: when it's coming to an end. People are accustomed to ranking areas of the country based on availability of high-quality arts, universities, restaurants, parks and recreation and health-care quality overall. Using data from the Dartmouth Atlas - a source of information and analytics that organizes Medicare data by a variety of indicators linked to medical resource use - we recently ranked geographic areas based on markers of end-of-life care quality, including deaths in the hospital and number of physicians seen in the last year of life. Doctors know this, which may explain why 72 percent of them die at home. ![]() Instead, many of us die in hospitals, subject to overmedication and infection, often after receiving treatment that we do not want. In California, for example, 70 percent of individuals surveyed said they wish to die at home, yet 68 percent do not. Where do you want to die? When asked, the vast majority of Americans answer with two words: "At home."ĭespite living in a country that delivers some of the best health care in the world, we often settle for end-of-life care that is inconsistent with our wishes and administered in settings that are unfamiliar, even dangerous. ![]()
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