Epidemiology of Do-Not-Resuscitate Orders

Disparity By Age, Diagnosis, Gender, Race, and Functional Impairment

Published in: Archives of Internal Medicine, v. 155, no. 19, Oct. 23, 1995, p. 2056-2062

Posted on RAND.org on January 01, 1995

by Neil S. Wenger, Marjorie L. Pearson, Katherine Desmond, Ellen R. Harrison, Lisa V. Rubenstein, Katherine L. Kahn, William H. Rogers

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Examines the sample of patients with DNR orders in the DRG Quality of Care Study to determine the relationship between DNR orders and patient and hospital characteristics. The study found that after adjustment for sickness at admission and functional impairment, DNR orders were assigned more often to older patients and also differed by diagnosis (highest among CVA patients, lowest among acute myocardial infarction patients). After adjustment for patient and hospital characteristics, the study found that DNR orders were assigned more often to women and to patients with dementia or incontinence and less often to black patients, those with Medicaid, and patients in rural hospitals. Further evaluation is needed to determine whether the variations observed in this study represent differences in patient preferences or care compromising patient autonomy.

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