By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    What Are the Benefits of CBD?
    November 27, 2021
    How to Measure Adult Diapers- The Ultimate Guide to Picking the Right Size
    March 8, 2022
    medicine cabinet
    The Effect Of Finished Dosage Form Manufacturing In New Drugs
    July 5, 2022
    Latest News
    6 Essential Strategies for Improving Your Medical Practice
    January 25, 2023
    Staying Positive While Living with Mesothelioma
    January 24, 2023
    The Many Health Benefits of Being Outdoors
    January 17, 2023
    How to Assess a Safe Placement of a Nasogastric or Nasoenteric Tube and Its Complications
    January 19, 2023
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    Who Will Save the Independent Physicians?
    February 2, 2013
    Image
    Caring For Chronic Illnesses Should Be Different
    May 26, 2013
    hospital bureaucracy
    Don’t Let Paperwork Get in the Way of Your Work’s Purpose
    September 25, 2013
    Latest News
    Simplifying the Genetic Testing Process: How At-Home Kits are Changing the Game
    January 25, 2023
    9 Hospitals That Have Introduced Green Initiatives
    January 25, 2023
    Why a Health Retreat Can Be the Best Medicine
    January 12, 2023
    Best Money-Saving Tips for Health Managers
    January 12, 2023
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: They Call This Research?
Share
Sign In
Notification Show More
Latest News
ABA therapist
Everything You Need to Know About Applied Behavior Analysis
Health
Small Lifestyle Changes That Can Have A Big Impact On Your Well-Being
lifestyle Wellness
The Future Of Medicine: How Immunotherapy Is Saving Lives
The Future Of Medicine: How Immunotherapy Is Saving Lives
Technology
medical practice and technology advancement
6 Essential Strategies for Improving Your Medical Practice
Technology
digital dental x-ray
How Does A Digital Dental X-Ray Work?
Dental health
Aa
Health Works CollectiveHealth Works Collective
Aa
Search
Have an existing account? Sign In
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Business > Hospital Administration > They Call This Research?
Hospital AdministrationPolicy & Law

They Call This Research?

JohnCGoodman
Last updated: 2011/04/26 at 1:16 PM
JohnCGoodman
Share
7 Min Read
SHARE

The Dartmouth Health Atlas has come out with another one of its national breakdowns of Medicare claims, showing a wide variation between areas. This one is focused on end-of-life care for people with chronic illnesses. The authors do their usual job of putting vast amount of data into very colorful maps, which add up to absolutely no understanding of what is going on. They find, for instance, that:

The Dartmouth Health Atlas has come out with another one of its national breakdowns of Medicare claims, showing a wide variation between areas. This one is focused on end-of-life care for people with chronic illnesses. The authors do their usual job of putting vast amount of data into very colorful maps, which add up to absolutely no understanding of what is going on. They find, for instance, that:

Widespread regional variation persists in measures of end-of-life care. In 2007, the percentage of deaths in hospital varied by a factor of almost four across hospital referral regions, and the average number of hospice days per patient in the last six months of life varied by a factor of more than six.

For in-hospital deaths, the study finds that:

More Read

cybersecurity options for hospitals

Should Hospitals Use SASE or Traditional Network Security?

6 Tips for Getting Into Medical School
Do You Need Life Insurance? What Does It Cover?
5 Ways New Technology is Revolutionizing Health
Are your Health Workers Properly Protected?

In 2007, the highest rates of death in hospital were in regions in and around New York City, including Manhattan (45.8%), East Long Island (41.9%) and the Bronx (39.9%)… In Minot, North Dakota, [by contrast,] only 12.0% of patients died in a hospital. Fort Lauderdale, Florida (19.0%) and Portland, Oregon (19.6%) were also among the regions with the lowest rates.

For lengths of hospital stays in the last six months of life, they found:

In 2007, patients in Manhattan spent, on average, 20.6 days in the hospital during their last six months of life, almost four times more than patients in Ogden, Utah, where the average was 5.2 days.

Now the authors claim that they have accounted for variations in populations and adjusted for that:

Although it is possible that some of the differences across hospitals may be explained by differences in patients’ preferences for care, studies show that regional variation in patient preferences overall explains very little of the variation in the intensity of end-of-life care. Differences in patient populations themselves also explain some of the variation in care. But by examining patients close to the end of life who are similarly ill with severe chronic diseases, and by adjusting for differences in age, sex, race and illness—as the data in this report have been adjusted—it is possible to account for most of the variation in patient populations, leaving variation caused by other factors, such as the availability of medical resources and the practice styles of health systems and clinicians. As this report shows, the remaining variation is substantial, both in the use of medical care and in trends in end-of-life care.

So the authors smugly assume that by adjusting for age, sex, race, and illness, they have eliminated any population differences that might contribute to different courses of treatment.

Golly, might there be anything else that distinguishes people in New York City from people in Ogden, Utah or Minot, North Dakota that might cause one population to be treated differently at the end of their lives? Let’s put on our thinking caps and noodle on this really, really hard.

Just maybe some people have different family structures and living conditions that enable them to stay at home during their last days, and just maybe these conditions are more favorable in Ogden and Minot than in New York. Conditions such as:

  • Owning their own homes.
  • Having intact families around, including adult children.
  • Being strongly religious, especially Mormon in Ogden.
  • Living in the same community all their lives.
  • Residing in one or two story homes, rather than walk-up apartments.
  • Having well-established networks of friends and civic associations.
  • Enjoying a low rate of crime.

The Dartmouth researchers saw no need to ask about any of these conditions. They were content with things like race and gender. But like most health policy researchers, these folks view patients as slabs of flesh to be pushed around rather than as fully-realized adult human beings.

It is true they had the patients fill out a “patient preferences” questionnaire, but just because someone may “prefer” to die at home doesn’t mean they are practicably able to do so.

Now this is no obscure research project with little effect on real-world policy. Indeed, one of the authors, Elliot Fisher, is the primary force behind this administration’s devotion to Accountable Care Organizations. If the thinking going in to ACOs is as limited as the thinking in this paper, we can be assured that the needs of actual real-life patients will be well down the list of priorities.

One final thought: If you download the study and look at the pretty maps, you will notice an almost perfect correlation between the areas where people most often die in the hospital and the areas where people are most likely to vote for Democrats. So here is another variable that stands out — the political orientation of the population. Is it possible that Democratic patients have an entitlement mentality that demands they be taken care of, while Republican patients are more self-reliant? Inquiring minds want to know.

   

TAGGED: health care policy, hospitals, research

Sign Up For Daily Newsletter

Be keep up! Get the latest breaking news delivered straight to your inbox.
By signing up, you agree to our Terms of Use and acknowledge the data practices in our Privacy Policy. You may unsubscribe at any time.
JohnCGoodman April 26, 2011
Share this Article
Facebook Twitter Copy Link Print
Share
Previous Article Caregiver Webinar Tomorrow
Next Article Status Update on Reform Law’s Temporary High Risk Pools

Stay Connected

1.5k Followers Like
4.5k Followers Follow
2.8k Followers Pin
136k Subscribers Subscribe

Latest News

ABA therapist
Everything You Need to Know About Applied Behavior Analysis
Health January 26, 2023
Small Lifestyle Changes That Can Have A Big Impact On Your Well-Being
lifestyle Wellness January 26, 2023
The Future Of Medicine: How Immunotherapy Is Saving Lives
The Future Of Medicine: How Immunotherapy Is Saving Lives
Technology January 26, 2023
medical practice and technology advancement
6 Essential Strategies for Improving Your Medical Practice
Technology January 25, 2023

You Might also Like

at-home genetic testing method kits
Global Healthcare

Simplifying the Genetic Testing Process: How At-Home Kits are Changing the Game

January 25, 2023
green hospitals
Hospital Administration

9 Hospitals That Have Introduced Green Initiatives

January 20, 2023
benefits of going on a health retreat
Global HealthcareHealth

Why a Health Retreat Can Be the Best Medicine

January 12, 2023
saving money in healthcare
BusinessGlobal HealthcareHospital Administration

Best Money-Saving Tips for Health Managers

January 12, 2023
//

We influence million of users and is the most authentic source of information on healthcare business and technology news.

Quick Links

  • About
  • Contact
  • Privacy
Subscribe

Subscribe to our newsletter to get our newest articles instantly!

Follow US

© 2008-2023 HealthWorks Collective. All Rights Reserved.

Removed from reading list

Undo
Welcome Back!

Sign in to your account

Lost your password?