End-of-Life Care Costs Differ Greatly Across the Nation

According to a recent Los Angeles Times article, end-of-life care cost Medicare sixty percent more for Los Angeles area patients than other areas of the country. In dollar figures, for care in the last two years of life, Medicare paid $112,000 per patient, while the national average was $70,000. Using data from the Dartmouth Atlas of Health, the article noted that in LA, patients spent about 13 days in hospice care as compared to the national average of 21, while the number of people enrolled in hospice care increased from 29% to 35%.

The report found that the increase in hospice use was uneven across academic medical centers nationwide. The Hospital of the University of Pennsylvania in Philadelphia had a 55% increase in the average number of hospice days per patient, whereas six academic medical centers experienced a decline of over 20% in the average number of hospice days, including the University of Mississippi Medical Center in Jackson, which decreased its number of days by 42.7%.

The report noted that rapid improvement was shown in many places but that some hospitals continue to receive more aggressive and less palliative care than others, for reasons that are not widely understood. As the Times reports, researchers disagree as to why costs in LA are higher, with some speculating it is due to pressure to fill available hospital beds. In related news, the California Office of Statewide Health Planning and Development is beginning meetings in Sacramento and Los Angeles on the development of new building standards for hospice facilities, the result of Senate Bill 125, which allows hospices to offer inpatient care at a free-standing health facility.