Terminal cancer treated too aggressively

The best hospitals in the United States don't do much better than local community hospitals when it comes to caring for dying cancer patients, researchers say. The study published in the journal Health Affairs said hospitals in general fail to consistently fail to meet recommendations for end-of-life care. Dr. Nancy E. Morden of the Dartmouth Institute for Health Policy and Clinical Practice said National Quality Forum terminal cancer standards include: having lower rates of use of the intensive care unit in the last month of life, use of chemotherapy in the last 14 days of life, deaths not occurring in the hospital and the use of hospice care for more than three days. Following the guidelines matters because it helps determine whether patients with short life expectancies receive relatively high levels of comfort-focused, palliative services or die after receiving uncomfortable treatments unlikely to prolong or enhance the quality of life, Morden, the study author, said. "Each hospital needs to examine the care it provides to patients believed to be nearing death, and question its alignment with patient preferences -- whether they be for early supportive care or aggressive treatment in the last days of life," Morden said in a statement. The analysis included more than 215,000 Medicare patients with poor-prognosis cancer -- likely to die within a year -- and the care provided to them at approximately 4,400 hospitals nationwide from 2003 through 2007. The researchers compared the care experienced by patients at hospitals with distinct characteristics -- community hospitals, academic medical centers, for-profit and non-profit hospitals, in addition to those with special cancer care designation such as National Cancer Institute centers.