Fewer people are dying in hospitals, according to a new study by Oregon Health And Science University and Brown University.
Lead researcher Joan Teno says people generally prefer to die at home or in an assisted living facility, surrounded by family — rather than attached to a machine in an intensive care unit. And she found that in-hospital deaths decreased from 33 percent in 2000 to about 20 percent in 2015.
In addition, the number of patients being moved to different health care facilities during the last three days of life decreased from 14 percent in 2009 to less than 11 percent in 2015.
"This tells me we're on the right path," said Teno, who is a senior scholar at the OHSU Center for Ethics in Health. "We're listening to people who tell us they don't want to die in a hospital setting as we're expanding access to hospice and palliative care teams."
Teno said it's not easy to tease out the reasons why fewer people are dying in hospitals, but she thinks penalties introduced in the Affordable Care Act are playing a role. The penalties are aimed at stopping hospitals from circling patients in-and-out.
“Hospitals now care about where they send their people, they want to avoid these penalties,” she said. “And so they’re doing a better job of discharge planning for patients that have to go to a nursing home or to home, to avoid those re-hospitalizations.”
A decrease in moving patients from one health care setting to another is particularly important, she said, as it can be stressful for patients nearing the end of life.
“Anytime you change health care settings there’s a whole new set of providers who need to get to know you,” Teno said.