Getting Services Right for Those Sick Enough to Die
Published in: BMJ, British Medical Journal, v. 334, no. 7592, Mar. 10, 2007, p. 511-513
Posted on RAND.org on January 01, 2007
Most people believe their lives will be relatively healthy, punctuated by episodes of illness that last no more than a few weeks. On the rare occasions that the authors think about dying, they imagine short and overwhelming illness in old age. Healthcare systems are designed as if disability and ill health were aberrations, rather than a phase that lasts months or years near the end of our lives, despite the contrary evidence all around us. Because of improvements in sanitation, lifestyle, and medical care, only a small proportion of people in developed countries now die suddenly. Most serious chronic illnesses cannot be catered for adequately by traditional hospital and surgical services, and substantial restructuring is needed. The numbers of people living with serious chronic conditions in old age will double in the next two decades in the United States, and similar trends will be seen in many other countries.