The information is fascinating, but the fact that they have gathered the information and then used it to direct medical students to hospitals where they might learn addressing needs at the end of life is even more fascinating!
“The Dartmouth Atlas of Health Care uses Medicare data to understand differences in medical care across U.S. hospitals… This report is part of a new effort to provide medical students with information about the patterns of care provided by teaching hospitals with residency training programs…. This report offers shines a light on hospital characteristics that are often invisible but are part of the hidden training curriculum that can affect a lifetime of practice.
These include how aggressively physicians ateach hospital treat chronically ill patients at the end of life, and the frequency with which patients undergo surgery when other treatment options are available. The authors of this report (who are physicians in training) believe that the wise use of health care resources and respect for patient preferences are just as important as learning to work up a patient….
Most importantly, for many patients with chronic illness, more hospital days do not lead to a longer or better quality of life. Use of ICUs and reliance on hospice: Many heroic and life-saving measures occur in ICUs, where aggressive efforts are made to resuscitate patients and keep them alive. There are times, however, when these measures are more harmful than heroic—and they may be unwanted by the patient. In hospitals where a high percentage of deaths occur in the hospital and in the ICU, there is less emphasis on hospice care.
After comparing hospitals, the authors suggest where medical students may prefer to learn, and where they may be better trained in having discussions with patients about their preferences for end-of-life care.”
Way to go Dr Aurora and Dr True! This is a valuable tool for medical students, and to hospital leaders who may examine the data and understand more about their biases in providing acute, intensive care vs hospice care.