Chronically ill patients at the University of Minnesota Medical Center are far less likely to die in the hospital than those at most other academic medical centers, according to a new national study of end-of-life care.
That may reflect a change in care patterns taking place across the country, with doctors less likely to press for expensive, invasive and sometimes unwanted care for dying patients, according to the respected Dartmouth College Atlas Project.
The study, which compared treatment in the last six months of life for patients who died in 2003 and in 2007, is the latest in a series of reports that put a spotlight on end-of-life care.
Among 94 academic medical centers, the university hospital was 27th lowest in 2007, the most recent figures available.
Overall, Minnesota hospitals performed better than the national average on several key measures: the percent of deaths in hospitals; the average number of hospital days during each person's final six months; and the percent of patients who saw 10 or more doctors during the last six months of life -- factors that have led to lower Medicare costs in Minnesota than elsewhere.
Still, the study found that the percent of deaths at University Medical Center has increased since 2003, when it ranked 4th lowest.
"I'm not really surprised," said Dr. Craig Weinert, medical director of the hospital's intensive care unit. "We do a good job helping patients and families understand their choices, but we are where very ill people come for answers, and that can lead to more deaths."
The hospital's figures may improve next year, he noted, when it launches a tele-medicine system, so its intensive care specialists can help guide intensive care in the six other hospitals in the Fairview system.
"We may not drop much," Weinert said. "Much depends on other factors. Our goal is to help patients and families make the best choices they can."