As a result of advances in public health and the development of lifesaving medical technology, Americans live longer than ever. Death, when it comes, often follows a chronic or progressive illness.
Unfortunately, the care received near the end of life often does not reflect a person’s values, goals, and informed preferences. Although the majority of people say they would prefer to die at home, two-thirds of Medicare beneficiaries die elsewhere, such as a hospital’s intensive care unit. People frequently endure unwanted treatment and suffer from inadequate pain management and shortness of breath, which often puts an enormous stress on family caregivers. A fragmented medical system and a lack of communication among doctors, patients, and families may result in less than optimal patient experience. But difficulties in the health care system may also be caused by the reluctance of patients, families, and doctors to discuss options and the alternatives to further treatment. Having these conversations early in the course of a serious illness is important, because most people who are near death are unable to communicate their wishes.
Pew seeks to improve end-of-life care by advocating for policies that help people make informed decisions about their treatment preferences, improve the documentation of these preferences, and hold health care providers accountable for honoring patient wishes and delivering high-quality care. Additionally, the project will highlight innovative ways of providing care to seriously ill people and their families as the patients reach the end of their lives.
For more than 20 years, quality measures—tools used to assess health care processes or patient outcomes against recognized standards—have proliferated in nearly all areas of medicine, helping providers improve patient safety, reduce hospital readmissions, and better manage chronic diseases such as diabetes. However, quality measures for end-of-life care are a glaring exception: The... Read More
Electronic health records (EHRs) have the potential to dramatically increase physicians’ ability to provide the right care at the right time by making sure they know a patient’s treatment preferences and values. Read More