Poor Care Leads to Early Death
Posted by Patti on August 15th, 2005 / Print This Post
I’m surprised this is even making news. Of course poor quality care will result in deaths and disease. Sometimes I wonder who funds these studies.
MONDAY, Aug. 15 (HealthDay News) — Older patients in declining health who receive fewer recommended tests or treatments for the conditions they suffer from are at greater risk of dying after three years than their peers who get higher quality care, a new study finds.The researchers say their study is the first to show that broad-based “process of care” measures can be used to predict patient survival among vulnerable elderly individuals.
Put simply, when doctors provide care that’s consistent with recommended guidelines — whether it’s assessing the functional status of a dementia patient, checking the blood sugar of someone with diabetes, or administering a pneumococcal vaccine to ward off pneumonia — patients do markedly better.
“Better quality meant better outcome,” said Dr. Paul G. Shekelle, a consultant in health sciences at RAND Health and one of the study co-authors.
The report appears in the Aug. 16 issue of the Annals of Internal Medicine.
Among patients who received more recommended care, 18 percent died after three years compared with 28 percent of those who received less care, the study found.
“We were expecting to see a relationship,” said Shekelle, who is also a physician at the Greater Los Angeles VA Healthcare System, “but we were surprised at the strength of it.”
Dr. Harlan M. Krumholz, a professor of medicine, epidemiology and public health at the Yale University School of Medicine, said, “The reason an article like this is important is because, at a time when we’re spending more and more money on health care and being drawn to fancier innovations, studies like this tell us we’re not even doing the basics.”
The new results come from an ongoing project called Assessing the Care of Vulnerable Elders (ACOVE), a collaborate initiative of Rand Health and Pfizer Inc. Earlier findings showed that older patients at risk of declining health receive only a portion of recommended care and receive recommended medications only half of the time.
September 6th, 2005 at 4:19 pm
This article, and I confess I have only read the above portion at the time of making this response, assumes that death is a negative outcome. If a person is in declining health, with dementia, dependent in cares and has limited human response to stimuli, prolonging their decline and death is not necessarily a positive outcome. I have worked in hospice for many years and it has been my observation that persons allowed to stay in their homes with their families and only be dependent in all cares during a limited period of time when death is imminent is often preferable to people able to make the decision in advance. I’m not saying withold necessary cares for purposes of quality of life but I do think doing extensive diagnostic procedures etc. on persons in the declining stage of life should not just be unquestioned as appropriate care.
Thanks