(HealthDay News) — Family-reported quality of end-of-life care is significantly better for patients with cancer or dementia than for patients with other chronic conditions, according to research published online June 26 in JAMA Internal Medicine to coincide with presentation at AcademyHealth’s Annual Research Meeting, held from June 26 to 28 in Boston.
Using medical records and results from the Bereaved Family Survey, the researchers reviewed data from 146 hospitals in the VA health system for patients who died between 2009 and 2012.
Among 57,753 patients, half of those with end-stage renal disease, cardiopulmonary failure, and frailty received palliative care consultations, compared with 74 percent of cancer patients and 61 percent of dementia patients. About one-third of those with end-stage renal disease, cardiopulmonary failure, and frailty died in an intensive care unit; 13.4 percent of cancer patients and 8.9 percent of dementia patients died in intensive care units. Cancer and dementia patients were more likely to have “do not resuscitate” (DNR) orders. Around 94 percent of those with cancer and dementia had a DNR, compared to 87 percent of those with other conditions.
About 60 percent of families of cancer and dementia patients rated the end-of-life care as excellent. About 54 percent of families of patients with other conditions gave a similar rating, the researchers found. “Increasing access to palliative care and goals of care discussions that address code status and preferred setting of death, particularly for patients with end-organ failure and frailty, may improve the overall quality of end-of-life care for Americans dying of these illnesses,” the authors write.