In this month’s “Health Affairs” a study confirms something we already know. We should explore end-of-life choices long before the end of life.
Some findings from the report:
• Emergency department use contributes to high end-of-life costs
• Over 50% of a population age 65 and older, visit an emergency department in their last month of life.
• Of those, 77% are admitted and 68% die in the hospital.
• The study compares patients who enroll in hospice at least one month before death rarely visit the emergency department in the last month of life.
The study concludes that policies that encourage the preparation of patients and families for death and early enrollment in hospice prevent emergency department visits at the end of life.
We should all be concerned that in a recent report by the Center for Medicare and Medicaid Services (CMS) published in “Health Affairs” that health care costs will once again grow faster than the economy. By 2021 spending will be growing roughly 2 percentage points faster than the overall economy…about the same rate as the last 30 years.
So what is all this talk about innovations in health care? I thought advances in evidence-based medicine and accountable care organizations (ACOs) were going to “bend the cost curve”. Some of this is actually being put into place and Vermont may be doing a better job of it than others. But nationally, the issue in health care spending is the fact that we are entering a burst (maybe a bust) in demand for medical services…the boomers are coming of age.
The study suggesting that there is significant savings to our health care system if we prepare for end-of-life issues should be taken very seriously. It is further evidence that there are low tech solutions to health care costs that we can control by exercising our right to personal autonomy.