August 2012 Review – Palliative Care and POST: Enhancing End-of-Life Care in Virginia

August 3, 2012

The American health care system is facing pressure to deliver high quality care at a reduced cost. As the population ages the need for health care services increases. Our health care system must seriously consider different models of care for those suffering from chronic progressive illness.

Notably, more than 90 million Americans live with at least one chronic illness. Seven out of 10 Americans die from chronic progressive life-limiting diseases (such as cancer, congestive heart failure, dementia and chronic obstructive pulmonary disease). Accumulating data suggests that many patients with these
illnesses undergo costly procedures that are unlikely to provide benefit in the last weeks to months of life, including the close to 10 percent who undergo surgery in the last week of life; and 15 percent who receive chemotherapy in the last two weeks of life. Many patients spend their last days shuttling back and forth between home, long-term care facilities, hospitals and even intensive care units. For patients with life-limiting illnesses, increased intensity of care does not necessarily result in improvements in length or quality of life. These treatments may not reflect the real needs and desires of patients with life-limiting illnesses and their families.

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