Study maps changes in end-of-life care--less hospital time, more doctors

From 2007 to 2010, the use of hospital services in the last six months of life fell significantly, with a 9.5% decrease in hospital days per patient and an 11% decrease in deaths occurring in the hospital, according to a Dartmouth Atlas report released earlier this month. The percentage of patients enrolled in hospice care increased by 13.3% and the average number of hospice days rose by 15% during that time period. The number of days patients spent in intensive care units changed little (3.8 to 3.9 days), but this reflects a leveling off of the rising ICU use seen prior to 2007, the report stated.

The number of physician visits was also stable (29.6 to 29.1 visits), but visits were spread over a greater number of doctors, according to the report. Forty-two percent of patients dying in 2010 saw 10 or more different physicians in their last six months of life compared to 36.1% in 2007, a 16.5% increase. Despite the trend toward less hospital care, Medicare spending per patient in the last two years of life rose from $60,694 to $69,947, a 15.2% increase during a period when the consumer price index rose only 5.3%.

Source: Dartmouth Atlas Report