End-of-life Talks Between Cancer Patients And Doctors Lead To Better, Less Costly Care

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Terminal cancer patients get better care, with lower costs, in their final days if they have talked to their doctors about their end-of-life choices beforehand, claim Harvard Medical School researchers.

The authors believe end-of-life discussions help advance-stage cancer patients better prepare for the inevitable health care decisions as they approach death and to what extent they want expensive medical interventions. But only 31% of the 600 cancer patients interviewed for the study reported to have had these types of discussions with their doctors.

"As the nation looks to ways to improve patient care and reduce costs of health care, end-of-life conversations should be considered,” reports Holly Prigerson, the study’s senior author and professor of psychiatry at Harvard Medical School.

The study found that patients did not necessarily benefit from aggressive and expensive life-saving measures in their final days. “Higher costs were associated with worse quality of life,” the authors concluded.

“We refer to the end-of-life discussion as the multimillion-dollar conversation because it is associated with shifting costs away from expensive, burdensome, noncurative care like being on a ventilator in an intensive care unit, to less costly comfort care provided at home or in hospice,” states Dr. Prigerson in an Harvard Science news article.

For more details on this report, click on:
HarvardScience online article, March 9, 2009:
http://www.harvardscience.harvard.edu/medicine-health/articles/end-life-conversations-associated-with-lower-medical-expenses

Zhang, B., et al., March 9, 2009. “Health Care Costs in the Last Week of Life,” Arch. Internal Med. : http://archinte.ama-assn.org/cgi/content/abstract/169/5/480

See EmpowHer related links on this topic:
Advanced Directives Are Just One Factor Physicians Consider When Making End-of-Life Treatment Decisions,”
https://www.empowher.com/media/reference/advance-directives-are-just-one-factor-physicians-consider-when-making-end-life-trea

For additional information, go to:
National Cancer Institute, “End-of-Life Care: Questions and Answers”
http://www.cancer.gov/cancertopics/factsheet/Support/end-of-life-care