Many initiatives to improve the quality of end-of-life care focus on cancer as the terminal diagnosis while other illnesses receive little attention. In June, JAMA Internal Medicine published a retrospective, cross-sectional study of over 57,000 patients within the Veterans Affairs health system that examined differences in rates of palliative consults, DNR orders, ICU stays, and family satisfaction based upon diagnosis. Researchers reported greater access to palliative care for those with cancer and dementia, resulting in less than half dying in the ICU compared to those with ESRD, cardiopulmonary failure, or frailty. Rates for quality end-of-life care were also higher for those with cancer or dementia but mediated by palliative care consultation for those in the end organ failure or frailty.
Link to JAMA Internal Medicine abstract (6/2016)