Strategies Vary By Region, but More Is Not Always Better

More than 90 million Americans suffer from chronic illnesses such as cardiovascular disease, diabetes and cancer… and 32% of Medicare spending was dedicated to end-of-life-care for patients with these chronic conditions between 2001 and 2005. Yet a recent report at Dartmouth Medical School uncovered startling regional variations in the intensity and cost of this care. Their findings: Though in some regions of the country older patients get more costly and aggressive care than in others, there is generally no difference in mortality and in some cases patients even die slightly sooner.

CARE AND COST VARY WITH GEOGRAPHY

In The Dartmouth Atlas of Health Care 2008, researchers analyzed records of elderly Medicare beneficiaries who died from common chronic diseases — congestive heart failure, lung disease, coronary artery and circulatory disease, cancer, dementia, diabetes and kidney or liver disease. Collectively, these chronic ailments are responsible for the deaths of 90% of people 65 and over.

How these individuals were cared for in their last months of life varied widely across the country, researchers discovered. Care ranged from conservative (fewer doctor visits, fewer days in the hospital and fewer days in intensive care, and a greater emphasis on primary care) to aggressive measures (more doctor visits, more days in the hospital and in intensive care, and more consultations with specialists). Not surprisingly, there were corresponding differences in cost, with Medicare expenditures reflecting startling regional differences. The average Medicare cost per patient in the last 24 months of life ranged from over $57,000 in Manhattan to $15,000 in Dubuque, Iowa. Only a third of this is due to difference in price. The other two-thirds reflect differences in the intensity of care.

This isn’t just about care provided to the elderly at the end of their lives, either. According to coauthor David C. Goodman, MD, a professor of pediatrics and of community and family medicine at Dartmouth Medical School, patients of all ages can generally expect more aggressive treatment in regions with higher bed supply and more physicians. Critical to realize, however, is that more care doesn’t translate to better results.

MORE CARE IS NOT ALWAYS BETTER CARE

The Dartmouth researchers found the discrepancies may have more to do with available resources than diagnosis. In areas where there are lots of doctors and hospitals and high-tech healthcare is widely available, patients get more aggressive care.

In areas with high intensity of care and high costs, patients spent on average 22 days in the hospital and made 60 visits to physicians in their final six months, contrasted with low-cost areas, where the averages were six days in the hospital and 15 doctor visits. While aggressive care provides more services for patients — more diagnostic tests and more procedures, more visits to specialists, longer hospital stays and longer periods in intensive care — all of the patients in the Dartmouth report had the same outcome (death). In other studies, the Dartmouth team has shown that higher regional intensity of care for patients with hip fracture, heart attacks or colorectal cancer (all of which require hospitalization but are not necessarily fatal) is associated with little difference in outcomes, and in some cases even a slightly higher death rate.

Problems arise as more hospitalizations expose people to more hospital-acquired infections and medical errors. The risk of harm can multiply when many doctors care for a patient, especially without careful coordination. Also, more diagnostic tests can find “abnormalities” that turn out to be harmless after many more tests, some of them with their own risks.

INCREASE YOUR ODDS OF BETTER CARE

According to Dr. Goodman, the remedy to this “needless variability in care and cost” is for the medical profession to develop and institute evidence-based guidelines on best practices. He believes reimbursement for care should reward better outcomes, not just higher volume of services. Until these reforms are in place, concerned healthcare consumers can take these steps to increase the odds of getting the best medical care…

  • Make sure your doctor understands and agrees with your philosophy about aggressiveness of care, overall — and if you have a chronic disease, as you go through the various stages of illness.
  • Ask questions. Inquire about the pros and cons, benefits and risks, for all recommended tests and procedures. For example, ask questions such as: Will the results of this test change my treatment? If not, why should I have it? What is the evidence that this intervention will help me? How will it affect my quality of life? What will happen if I decide not to have it? The fact that something can be done doesn’t mean it should be done.
  • Fill out an advanced directive and inform your doctor that you have done so. (Free forms are available at www.caringinfo.org.) Spell out your preferences for care in situations in which you may no longer be able to express your wishes. Think about whether you want invasive life-support treatments, such as a feeding tube or cardiopulmonary resuscitation, and under what circumstances.
  • Compare hospitals. Check how the Dartmouth group rates your local hospital’s management of chronic diseases at www.dartmouthatlas.org. In addition to the fact that there are regional trends toward more or less intense care, Dr. Goodman adds that there are also striking variations hospital to hospital, within regions. For example, if you live in Miami, which has a high healthcare intensity, go to the above Web site to find Miami hospitals that deliver relatively less intense, but still high-quality, care.
  • Take charge of coordinating your care or assign a trusted and assertive family member to the task. To avoid the consequences of fragmented care, send reports of all specialists’ visits, tests and treatments to your primary care provider. Also, make sure that he/she advises you on preventive measures — diet, exercise, etc. — to forestall complications and hospitalizations.

The high cost of medical equipment and the need for doctors to protect themselves from lawsuit provide motivating factors to prescribe treatments beyond patient wellness. In the end, medicine is a business and more care often means greater profits for healthcare providers, from the physician to the hospital to the drug and device manufacturers. Be sure that what your doctor is recommending is truly in your best interest.