The Quality of Care for Patients Dying in the Hospital: Areas for Improvement Suggest Fundamental Problem in U.S. Health Care

RAND Congressional Briefing Series


Neil Wenger

RAND Corporation

End-of-life care is an emotionally charged issue with a lot at stake in terms of lives and dollars. Medical care provided during the last year of life accounts for 10 to 12 percent of all U.S. health care spending, yet end-of-life care often does not reflect patient or family wishes. Seriously ill patients in hospitals may receive intensive, but unsuccessful, treatments and die with distressing symptoms after receiving burdensome care.

Despite the attention end-of-life care receives, little is known about what happens to people dying in the hospital or the nature and quality of care they receive. Neil Wenger examined the care provided to patients who died over a one-year period at the Ronald Reagan UCLA Medical Center and identified several critical areas in which the hospital could improve end-of-life care.

The study

  • describes who the patients are and how they die in the hospital
  • evaluates the quality of end-of-life care
  • was designed to help improve its quality of end-of-life care and offers lessons for physicians and other caregivers who treat critically ill patients nationwide
  • can help policymakers as they struggle to address payment systems and other issues pertaining to end-of-life care.

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