| Summary: | More than 1.5 million cancers are diagnosed each year in the United States. This Dartmouth Atlas report examines how elderly patients with poor prognosis cancer are cared for across regions and hospitals and finds remarkable variation depending on where the patients live and receive care. Even among the nation's leading medical centers, there is no consistent pattern of care or evidence that treatment patterns follow patient preferences. Rather, the report demonstrates that many hospitals and physicians aggressively treat patients with curative attempts they may not want, at the expense of improving the quality of their last weeks and months. While this report does not measure patient treatment choices directly, published research strongly indicates that care patterns near the end of life are partly driven by the local availability of health resources, such as hospital beds and new treatment technologies. In addition, communication with cancer patients and families often fails to include accurate information about prognosis and treatment options. These studies suggest that high hospital day rates and low hospice use are often signs of overly aggressive treatment. While many health systems have addressed some of these shortcomings, further work needs to be done to improve end-of-life care. The findings presented in this report provide a starting point for the longitudinal monitoring of further efforts to improve care for patients with poor prognosis cancer
|
|---|