Home Health & Hospice Week

University of Washington researchers set out to discover physician and patient attitudes about end of life care in a year-long study, but ended up focusing on physician handling of the matter instead. "Patients and family members sometimes feel abandoned by their physicians at the transition to end-oflife care," notes the study in the March 9 issue of the Archives of Internal Medicine journal.

"I think patients should expect more," the study's author, oncologist Anthony Back, told USA Today. "I don't think it's OK for them to talk to the doctor about hospice and never hear from the doctor again," he adds. "I think it just makes that whole process harder."

Many of the 55 patients with incurable cancer or advanced chronic obstructive pulmonary disease, 36 family caregivers, and 25 nurses interviewed for the study spontaneously brought up the topic of physician abandonment, the UW researchers say in the study. Physicians need to provide continuity of care during the transition and facilitate closure, the study authors recommend.

In another study published in the same journal, Boston University School of Medicine researchers found that black and Hispanic patients averaged higher medical costs in the last six months of life compared to white patients by 32 percent and 57 percent, respectively. Minority patients in general had less preventive care before end of life, then showed "strikingly greater use of life-sustaining interventions" in the last six months, the study notes.

A third study by National Institute of Mental Health and National Cancer Institute researchers in the journal noted that when patients had "end of life conversations" with physicians, they had significantly lower health costs in the last week of life. "Higher costs were associated with worse quality of death," said the authors of the study that interviewed 627 patients with advanced cancer.