Aggressive Care Increases Medicare Costs in Advanced Dementia

Aggressive Care Increases Medicare Costs in Advanced Dementia.tabnews{padding: 8px 0;margin-left: 0;margin-top: 1px;margin-bottom: 0;font: bold 12px Verdana;list-style-type: none;text-align: left; /*set to left, center, or right to align the menu as desired*/}.tabnews li{display: inline;margin: 0px;}.tabnews li a{text-decoration: none;position: relative;z-index: 1;padding: 8px 7px;margin-right: 3px;border: 1px solid #778;border-top: 3px solid #000080;color: #2d2b2b;background: #f0f8ff; height:31px;background-position: 0 .0em;}.tabnews li a:visited{color: #2d2b2b;}.tabnews li a:hover{text-decoration: underline;color: #2d2b2b;}.tabnews li a.selected{ /*selected main tab style */position: relative;top: 1px;}.tabnews li a.selected{ /*selected main tab style */background: #ffffff; border-bottom-color: white;}.tabnews li a.selected:hover{ /*selected main tab style */text-decoration: none;}.tabcontent{display:none;}.dbfl{display:block; float:left;}#latestOn{ display:block; float:left; width:290px; background-color:#DADADA; padding:5px;}#latestOn .tabs{ display:block; width:290px; background-color:#DADADA; }#latestOn .tabs a.dAct{display:block; float:left; padding:5px 2px; border-left:3px solid #DADADA; border-right:3px solid #DADADA; border-bottom:3px solid #DADADA; background-color:#E7E7E7; font-size:10px; font-weight:bold; text-decoration:none; color:#333333; }#latestOn .tabs a.active{display:block; float:left; padding:5px 2px; border-left:3px solid #FFFFFF; border-right:3px solid #FFFFFF; border-bottom:3px solid #FFFFFF; background-color:#FFFFFF; font-size:10px; font-weight:bold; text-decoration:none; color:#000080; }#latestOn .contentDiv{display:block; float:left; background-color:#FFFFFF; width:290px; padding-bottom:5px;}#latestOn .thumbDiv{ display:block; float:left; width:140px; padding-left:5px; padding-top:10px;}#latestOn .thumbDiv img{ display:block; float:left; padding:1px; border:1px solid #CCCCCC; margin-right:5px;}.dheight{ height:1%;}.dheight:after{ height:0; content:''; display:block; clear:both;}#SearchOn1{ display:block; float:left; width:665px; background-color:#C2E1F6; padding:5px;}#SearchOn1 .tabs{ display:block; width:665px; background-color:#C2E1F6; }#SearchOn1 .tabs a.dAct{display:block; float:left; padding:5px 2px; border-left:3px solid #C2E1F6; border-right:3px solid #C2E1F6; border-bottom:3px solid #C2E1F6; background-color:#C2E1F6; font-size:10px; font-weight:bold; text-decoration:none; color:#333333; }#SearchOn1 .tabs a.active{display:block; float:left; padding:5px 2px; border-left:3px solid #FFFFFF; border-right:3px solid #FFFFFF; border-bottom:3px solid #FFFFFF; background-color:#FFFFFF; font-size:10px; font-weight:bold; text-decoration:none; color:#000080; }#SearchOn1 .contentDiv{display:block; float:left; background-color:#FFFFFF; width:665px; padding-bottom:5px;}function fnsearch1(){ tmpcatid=document.search1.ncategoryid.value;tmpkeyword=document.search1.keyword.value;document.search1.action="http://www.medindia.net/news/newsday_list.asp?ncategoryid=" +tmpcatid +"&keyword=" +tmpkeywordreturn true;} Medindia On Mobile About UsPortfolioPressCareersSitemapAdvertiseContact Us Make this your Homepage @import url(http://www.google.com/cse/api/branding.css); Custom Search
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General Health News?? ?? ? Text? News Comments A large proportion of medicare expenditures for nursing home residents with end term dementia, a terminal illness, is spent on aggressive treatments that may be avoided, according to a study by the Institute for Aging Research, an affiliate of Harvard Medical School.

The study examined Medicare expenditures for 323 nursing home residents with advanced dementia in 22 facilities in the Greater Boston area as part of the Choices, Attitudes, and Strategies for Care of Advanced Dementia, or CASCADE, study. According to the findings, the largest proportion of Medicare expenditures was for hospitalizations (30.2%) and hospice (45.6%). Medicare expenditures rose by 65 percent in each of the last four quarters before death, primarily due to an increase in both acute care and hospice services. Acute care costs were lower among residents who had either a Do Not Hospitalize (DNH) order, lived on a special care dementia unit, or did not have a feeding tube.

"Our study demonstrates that a large proportion of Medicare expenditures in advanced dementia are attributable to acute and sub-acute services that may be avoidable and may not improve clinical outcomes," says senior author Susan L. Mitchell, M.D., M.P.H., a senior scientist at the Institute for Aging Research.

An additional 10 percent of Medicare expenditures were for care in a rehabilitation facility after hospitalization. Dr. Mitchell calls the benefits of skilled nursing or rehabilitative care for these patients "questionable," given that most of them are totally physically functionally and cognitively impaired.
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