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Research
Jan 1, 2008
Assesses evidence about interventions to improve palliative and end-of-life care.
Even in a system known for high-quality chronic illness care, documentation of advance care planning and proxies for health decisions at end of life was infrequent. Involvement of outpatient primary care and geriatric providers may improve care.
Finds variability in advance directive documentation for nursing home patients on transfer to the emergency department, and finds that emergency clinicians experience substantial difficulty in reliably obtaining information about advance directives.
Jan 1, 2007
The literature summaries that support each indicator judged valid by the expert panel are described.
Jan 1, 2003
Advanced care planning to avoid unwanted care at the end of life remains a low priority in patient care.
The authors discuss serious, recurring, and generally unnoticed errors in planning for care near the end of life and possible steps toward improvement
Jan 1, 2001
Half of all persons infected with HIV are at risk of making end-of-life decisions without prior discussions with their health care practitioners.
Jan 1, 2000
SUPPORT aimed to describe and compare decision-making affecting seriously ill patients, it also illuminated other aspects of their course near death.
SUPPORT documents that physicians and surrogates are often unaware of seriously ill patients' preferences.
Seriously ill hospitalized older patients were treated less aggressively than younger patients.
Physicians often misunderstand seriously ill, hospitalized patients' resuscitation preferences, especially preferences to forego CPR.
Prolonged ICU stays were expensive and were often followed by death or disability.
