Research by HMS scientists from the Center for Surgery and Public Health at Brigham and Women’s Hospital has found that on three of five measures of the intensity of end-of-life care, physicians received significantly fewer intensive interventions than the general population.
“Our analysis confirms what we’ve long speculated,” says Joel Weissman, an HMS associate professor of health care policy and deputy director and chief scientific officer at the Center, “which is that physicians, who are more likely to have firsthand experience with the burdens and futility of end-of-life care, are less likely to have surgery or be admitted to the ICU during the last six months of life, or to die in the hospital.”
Weissman wrote the research letter, which appeared in the January 19, 2016, issue of JAMA, with colleagues at the Mayo Clinic and the Center for Research on End of Life Care at Weill Cornell Medical College.
“Patients often ask their doctors what they would do or what they would choose for their own family members,” says Zara Cooper, an HMS assistant professor of surgery at Brigham and Women’s Hospital and co-author of the letter. “This research could have a significant impact on clinical practice, especially in the way that health care professionals communicate with patients and family members about end-of-life care options.”
The analysis included non-health maintenance organization Medicare beneficiaries aged 66 years or older who died between 2004 and 2011 in Massachusetts, Michigan, Utah, or Vermont, and was based on the availability of electronic death records and the ability to link to Medicare data.
The investigators note that additional research is needed to explore how complex decision-making processes and satisfaction with end-of-life care are related to these findings and to see whether the findings will hold true in other states once data become available.