Their newest study looks at end-of-life care provided to 4.7 million patients with chronic conditions such as cancer, heart failure and lung disease. These persons were hospitalized during the final two years of their life. The figures cover 1999 through 2003.
Their results show that on an average people spent the most time in hospitals, during the last 6 months of their life.
Most of them get aggressive treatments for their diseases, which they would not have actually preferred, had they known they had a choice. The alternative is palliative care.
They were kept alive by modern technology, wired to the latest medical gizmos and pumped with powerful drugs; all this when many would have preferred to spend their last days on palliative care, with their families and at home.
According to the Dartmouth researchers, if all hospitals had provided end-of-life care prudently, Medicare would have saved $40 billion from 2000 to 2003.
Doctors and hospitals are paid more to perform medical procedures aimed at keeping patients alive than they are to provide palliative care designed to keep patients comfortable as they die, says Myra Christopher, president of the Center for Practical Bioethics in Kansas City.
She adds, "It's crazy. The financial incentives are really quite perverse."