Archive for August, 2011

Patients or Healthcare Consumers? A tipping point in Hospice & Palliative Medicine

by AAHPM President Ronald J. Crossno, MD

Do we take care of patients or do we partner with educated consumers who are knowledgeable about healthcare economics? The answer is clearly some of both, depending on the individual in front of us, but a new report from the Deloitte Center for Health Solutions suggests the prospect of the engaged consumer is increasing. Two findings of this study may also indicate that US consumer attitudes may be changing in a way that may allow for systematic healthcare cost savings.

Deloitte surveyed almost 16,000 healthcare consumers in 12 countries, all with variously developed healthcare systems that often garner similar consumer responses despite their differences. One of those differences is how much of the country’s GDP is spent on healthcare, ranging from a low of 4.7% in China, to an average of 10-11% for most, to a high of 17.6% for the US. Per-capita spending in the US stands out at over $8,000, with no other country surpassing $5,000. However, in many other areas, there was considerable uniformity in answers. Most consumers believe themselves to be in “excellent” or “very good” health, despite roughly half of consumers saying they have been diagnosed with one or more chronic conditions. Data indicates that consumers are increasingly attuned to and knowledgeable about healthcare, in general.

Nevertheless, consumers in all countries rated their understanding of their country’s healthcare system as low and satisfaction with their current system also generally ranked low. Many indicated wasted spending as a major issue, with the most common cause of waste being identified as “redundant paperwork in the system.”

However, it is at this point that the US has another standout point. A common cause of waste identified by 35% of US consumers was: “At the end of life, extreme measures taken to extend life for a short period of time instead of making the person comfortable with things such as pain relief and palliative care.”

So the US spends considerably more than any other nation on healthcare, but consumers identify extreme measures at end-of-life as wasteful. Note that these are consumers – not policy-makers or healthcare professionals. Are these two items really related? Perhaps, though this study isn’t designed to answer that question.

To me, these findings suggest that there is a large group of Americans who innately understand the type of message that Hospice & Palliative Medicine provides – that individualized goal-setting to meet the specific wishes of individuals and their families at the time of life-threatening and serious illness provides the treatments wanted while resulting in overall cost savings. Either we’ve been successful in getting our message out or consumers figured this out on their own.

Both represent success, since all major movements require significant grassroots support in order to garner widespread institutional and/or governmental support for funding and full implementation. It appears that we may be crossing the tipping point for such support. Despite the economy (or perhaps because of it), HPM’s message is being heard. Let’s keep getting it out there!

Pacific Northwest Ahead of the Curve in End-of-Life Care. Or Is It?

by Joanna Fief

I’ve been hearing about the need for improved end-of-life care since I was a kid. My mom was a hospice nurse for many years and always talked about the importance of broader and earlier access to palliative care for patients and their families.

I never dreamed my work would overlap with hers, but for the past few years I’ve been working with The Regence Foundation, a grantmaking organization in the Pacific Northwest focused on increasing awareness and improving access to palliative care. Mom is proud of me, and I feel very lucky to work in a part of the country that is so ahead of the curve when it comes to end-of-life care.

Or is it?

Last month, The Regence Foundation partnered with National Journal, a media organization in Washington D.C., to poll people in the Pacific Northwest on their attitudes toward end-of-life care and how they compare with the rest of the country.

My gut feeling was confirmed. People here are generally more aware of and open to discussing end-of-life care options than other Americans. However, the poll also showed that, just like the rest of the nation, many still aren’t familiar with the term “palliative care.” Plus, about half said that information about palliative care is “available, but only if you know where to look or who to ask.” The Regence Foundation wants to change that.

For me, the key takeaway is that, regardless of geography, when people know what palliative care is, they want it, and I love that part of my job is to help them know what it is and how to access it.

Joanna Fief works at The Regence Group, a total health solutions company. The company’s foundation is called The Regence Foundation, which is working to improve access to palliative care.