What Difference Do Advance Directives Make?

December 30, 2011
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The results were surprising: The advance directives only saved money in areas where Medicare’s end-of-life costs are high. Think Florida and New York. In areas where Medicare’s costs are already low — say, Minnesota — there was no change in spending….

The results were surprising: The advance directives only saved money in areas where Medicare’s end-of-life costs are high. Think Florida and New York. In areas where Medicare’s costs are already low — say, Minnesota — there was no change in spending….

The big difference, in fact, was that patients with end-of-life directives in high-costs areas were more likely to die outside of the hospital than patients who didn’t have end-of-life directives. That suggests the end-of-life directives do not prevent emergency measures at the end of life. If a patient is about to die, doctors try and save them. But in a non-emergency context, when doctors have time to talk with the patient’s family about treatment options, they do prevent certain types of life-prolonging treatment.

Ezra Klein post. Study here [gated, but with abstract].