At Life’s End, Aggressive Care Still the Norm

By Alvin Tran, Kaiser Health News

(Photo/Kaiser Health News)

(Photo/Kaiser Health News)

While fewer older Americans are dying in hospitals, new research suggests that doesn’t mean they’re getting less aggressive care in their final days.

Even as deaths in acute hospitals declined between 2000 and 2009, the use of intensive care units in the final 30 days of life increased, as did short-term hospice use, according to a study of Medicare beneficiaries published Tuesday in the Journal of the American Medical Association. The rate of changes to care for these patients, such as transitions within the last three days of life, also increased.

Dr. Joan Teno at Brown University’s medical school led the study. She says the increased use of hospice is encouraging, but worries about when seniors are referred to hospice.

“While there is greater access to hospice services, there’s also more ICU, more repeat hospitalizations, and more late transitions in the last three days of life,” Teno said during an interview. “The good news is that we are referring to hospice. The bad news is we’re referring to hospice in the last hours of life.” Continue reading

The Good and the Bad of Cancer Care in California

By Rachel Dornhelm

The California HealthCare Foundation issued a new report on cancer in the state. (Flickr: briannaorg)

More than a million Californians are living with cancer, and a new report from the California HealthCare Foundation (CHCF) takes a look at how the disease has affected the population over time.

Stephanie Teleki, senior program officer at CHCF, says some of the most welcome news is about childhood cancers. While the likelihood of a child developing cancer has crept up, the rate of children in the state who die from cancer each year has decreased 21% over the last two decades.

Overall — looking at kids and adults — cancer mortality rates have fallen 22 percent since 1989 and rates of new cancer diagnoses have dropped 9 percent.

On the more sobering side, the report found persistent disparities across race. For instance the mortality rates in California for African Americans were 30 percent to 90 percent higher than in other groups for all cancers. And despite the fact that whites are more likely to be diagnosed with breast cancer, African Americans’ death rate from the disease is 40 percent higher. The inequity holds for prostate cancer, too: black men are two times more likely to die from that disease than whites. Continue reading