More senior citizens are dying at home - Miami-Dade - MiamiHerald.com

By John Dorschner

jdorschner@MiamiHerald.com

After years of experts and patients saying people at the end of life might be more comfortable dying at home, a new study says that may finally be happening: fewer seniors in the United States and South Florida are dying in hospitals.

But the same survey finds that in the last months of life for seniors throughout the United States and especially in Miami, the trend is for more of them to see large numbers of specialists and to spend more time in expensive intensive care units.

Those are the results of the latest study from the Dartmouth Atlas, a project of the Dartmouth Medical School. The project for years has been using Medicare data to expose anomalies in healthcare costs and wide geographic disparities in expenses.

“Miami is practically off the charts,” says David Goodman, a Dartmouth researcher who was the lead author of the study. “It really continues to stand out” for having the highest costs and most extensive treatments in the last months of life, even when adjusted for age, ethnicity, race and severity of illness.

via miamiherald.com

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Patients with do-not-resuscitate orders fare worse | Reuters

A new study could help people with a do-not-resuscitate order make better decisions about what surgeries they are willing to undergo.

About seven in 10 Americans die with such an order, which instructs healthcare workers not to use life-prolonging treatment if a patient's heart or breathing stops.

But other situations that aren't necessarily covered in the do-not-resuscitate, or DNR, orders may also be worth considering, researchers say.

The new report, out Monday in the Archives of Surgery, shows DNR patients have a higher chance of dying following surgery, although not with all kinds of procedures.

via reuters.com

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Tanning Bed Exposure Can Be Deadly When Complicated By Medication Reactions

The researchers said that a recent random study of 1,200 individuals indicated that nearly 10 percent of those who frequented tanning salons did so in response to treatment of skin disease and only 5 percent were doing so on the advice of a physician.

"There is an increasing trend for patients to seek tanning bed radiation exposure as a means of self-treatment because, among much of the general public, the perceived benefits of tanning bed radiation include its ability to treat rashes," the study noted.

This research was funded in part by grants from the Riley Memorial Association, the National Institutes of Health and a Veterans Administration Merit Award.

via medicalnewstoday.com

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The care was futile, and the patient's wishes, KevinMD.com

by Jim deMaine, MD

“We have a patient on a ventilator here who is stable enough to transfer to your ICU, if that’s OK with you.”

This call, coming from the transfer coordinator, is emblematic of an insurance generated “medical care” coverage issue. I am salaried under the patient’s insurance carrier so the insurer wants this patient back under its wing as soon as possible.

The community hospital has been keeping Stella Norris (not her real name), an 89 year old woman, as long as possible. She is incapacitated from a massive stroke suffered five years ago. There is a feeding tube inserted through the stomach wall and she has needed total body care. 911 was called when she stopped breathing and she was taken to the closest hospital.

via kevinmd.com

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