Economics at the end of life: hospital and ICU perspectives. [Review]

MedStar author(s):
Citation: Seminars in Respiratory & Critical Care Medicine. 33(4):362-9, 2012 Aug.PMID: 22875382Institution: MedStar Washington Hospital CenterDepartment: Medicine/Pulmonary-Critical CareForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *Hospitalization/ec [Economics] | *Intensive Care/ec [Economics] | *Palliative Care/ec [Economics] | *Terminal Care/ec [Economics] | Aged | Decision Making | Dementia/ec [Economics] | Heart Failure/ec [Economics] | Hospitalization/sn [Statistics & Numerical Data] | Humans | Intensive Care/sn [Statistics & Numerical Data] | Neoplasms/ec [Economics] | Physician-Patient Relations | Prognosis | Quality of Life | Terminal Care/es [Ethics]Year: 2012ISSN:
  • 1069-3424
Name of journal: Seminars in respiratory and critical care medicineAbstract: Not all feasible care is desirable care. At the end of life, aggressive interventions may not only be futile but also inappropriate because they may impair the quality of the remaining life for both the patient and the caregiver. Although it is challenging to identify patients with a poor prognosis, certain terminal conditions among the elderly, such as end-stage dementia, heart failure, and metastatic cancer, demand a more measured use of aggressive care. Frank discussions with patients and family about their desires in the context of the prognosis, as well as symptom support, can yield both economic savings and better quality of life. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.All authors: Shorr AF, Zilberberg MDFiscal year: FY2013Digital Object Identifier: Date added to catalog: 2013-09-17
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Journal Article MedStar Authors Catalog Article 22875382 Available 22875382

Not all feasible care is desirable care. At the end of life, aggressive interventions may not only be futile but also inappropriate because they may impair the quality of the remaining life for both the patient and the caregiver. Although it is challenging to identify patients with a poor prognosis, certain terminal conditions among the elderly, such as end-stage dementia, heart failure, and metastatic cancer, demand a more measured use of aggressive care. Frank discussions with patients and family about their desires in the context of the prognosis, as well as symptom support, can yield both economic savings and better quality of life. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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