Category: Access to Treatment

Aggressive Treatments at End of Life Linked to Worse Quality of Death:

“‘The more time patients spent under hospice care, the greater their quality of death,’ Mr. Silverman said. ‘For example, patients who received at least 5 weeks of hospice care were in less physical distress in their last week of life than those who lived less than a week with hospice, and those who received no hospice at all were in the most physical distress at the end of their lives. These results suggest that when patients are actively dying, the use of aggressive treatments should be considered with caution and only pursued with the full understanding of patients or their surrogate decision makers.’ “

Another pet topic of mine, poor end-of-life care. This is especially tragic, as it represents people being egged on to continue aggressive treatments with full knowledge that there will be no substantial benefit. The resources wasted by this are secondary to the human suffering, but they are massive.

Cheers.

ACP Online – ObserverWeekly – 14 August 2007: “Study: Expanding preventive services would save 100,000-plus lives Beefing up preventive care measures such as flu shots and cancer screenings would save more than 100,000 U.S. lives each year, a new study found. The Partnership for Prevention study found 45,000 fewer people would die each year if 90% of adults took aspirin daily to prevent heart disease, instead of the 50% taking it currently. Likewise, if 90% of smokers were given cessation advice, medicine and support by a health professional, 42,000 fewer people would die each year, the study found. Other measures that would save lives, if 90% of the target population received them, include: Colorectal cancer screenings for adults age 50 and over would save 14,000 lives. Fewer than 50% of these adults are screened now; Annual flu shots for adults age 50 and over would save 12,000 lives. Fewer than 37% get the shots now; Breast cancer screening every two years for women age 40 and over would save 3,700 lives. About 67% are screened now; and Chlamydia screenings for sexually active young women would prevent 30,000 cases of pelvic inflammatory disease annually. About 40% are screened now. The study also found African Americans, Hispanic Americans and Asian Americans were less likely to use preventive care than whites. That’s partly because many minorities lack continuity of health care or an ongoing relationship with a health professional who can help ensure preventive measures are taken, an expert said. The study was funded by the CDC, the Robert Wood Johnson Foundation and WellPoint Foundation. The Partnership for Prevention report is online here in pdf. “

Another data point for (inadequate) access to treatment and preventative services. In Sally Pipes piece, she comments about 10% of Canadians looking for a PCP. Ha!

Cheers,

Court Rules Out Terminally Ill for Tests – washingtonpost.com:

“Terminally ill patients do not have a constitutional right to be treated with experimental drugs, even if they likely will be dead before the medicine is approved, a federal appeals court said Tuesday. The ruling by the U.S. Court of Appeals for the District of Columbia Circuit overturned last year’s decision by a smaller panel of the same court, which held that terminally ill patients may not be denied access to potentially lifesaving drugs.”

Just thought I’d start gathering data points about access to treatment, as that seems to be brought up quite a lot in these discussions. My position is that these access issues will need to be carefully thought out and thoughtfully debated as we move to a single payer system.