Patients with advanced, almost certainly terminal illnesses face a wider range of choices about their end-of-life care, including hospice and even care at home. While the majority people say they would prefer to die at home, less than a third do so, often because of aggressive care that is not consistent with the patient’s wishes. A Cochrane review summarized in JAMA looks at multiple studies on the benefits and costs of palliative care in the home for these patients with advanced illness, compared to usual care. (JAMA Summary) The reviewers found 23 relevant studies from the period 1975-2007 (note that apparently an updated review is under way, this is a bit dated) most regarding cancer patients. Receiving palliative care at home was associated with a two-fold greater likelihood of dying at home. Patients also displayed or reported fewer symptoms, but evidence for other aspects of quality of life was inconclusive. Caregivers did not report experiencing less grief for patients who received home palliative care as opposed to usual care. While some studies suggested such care was cost-effective, meaning it cost less to provide than it saved in other medical spending, overall the authors concluded there was insufficient evidence to make a judgment about cost benefits. The most important thing, by far, is that patients have their wishes respected about where to die and if palliative home care aids in that goal, that should be sufficient to encourage its use. The updated review almost certainly will reflect even greater progress toward that objective.
✅ Subscribe via Email
About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
Healthy Skeptic Podcast
This is an outstanding report on total global drug spending and trends, with projections out to 2025. It helps you understand this important area of health care, which does much...
June 1, 2021
MedPAC 2019 Report to Congress
June 18, 2019
Athenahealth has done very well in the market for electronic medical records and other provider information systems. It is being sold by one set of investors to two private equity...
November 23, 2021
Investors may get the sharp end of the stick and swallow some losses, as Sword Health, which manages musculoskeletal conditions, raised an insane $163 million at an even more insane...
November 23, 2021
Crazy funding continues apace, as Medallion receives $30 million in new funding for doing something called digital health infrastructure which in this case just turns out to be helping doctors...
November 5, 2021
Access ACO Care Management Chronic Disease Comparative Effectiveness Consumer Directed Health Consumers Devices Disease Management Drugs EHRs Elder Care End-of-Life Care FDA Financings Genomics Government Health Care Costs Health Care Quality Health Care Reform Health Insurance Health Insurance Exchange HIT HomeCare Hospital Hospital Readmissions Legislation M&A Malpractice Meaningful Use Medicaid Medical Care Medicare Medicare Advantage Mobile Pay For Performance Pharmaceutical Physicians Providers Regulation Repealing Reform Telehealth Telemedicine Wellness and Prevention Workplace