A study published Online First in The Lancet holds that almost a third of elderly American beneficiaries of fee-for-service Medicare plan get avoidable surgery done during their last year of life. Most procedures are carried out in the month prior to death. This suggests that some surgeries could be either evaded or were optional, but it could also mean a financial incentive as surgical procedures are very costly, and therefore the surgery may not be according to the wishes of dying patients.
The researchers examined the occurrence of elderly Americans who had undergone surgery in the last year of life and whether important regional issues, like number of hospital beds and availability of surgeons influenced the provision of surgical interventions to dying patients. The researchers found out that almost one in five beneficiaries of fee-for-service Medicare who died in 2008 had surgery during the last month of their life, with almost one in ten patients undergoing a surgical procedure within their last week of life.
The authors Ashish Jha from the Harvard School of Public Health in Boston, USA, and his fellow researchers have noted that the findings implies that the accessibility of hospital heads per head, despite the number of surgeons, increases patients’ chances of receiving surgery at the end of life. High-intensity regions have nearly 40% more beds per head as compared to low-intensity areas and also have considerably higher Medicare spending.
The authors are apprehensive on the likelihood of elderly Americans receiving surgery at the end of life as a result of factors, like health-care provider practices and culture instead of appropriate medical care or individual patients’ preference.
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