استعرض مصدر Physicians Less Likely to Die in Hospital Than Other Patients



Physicians Less Likely to Die in Hospital Than Other Patients<ref>https://www.medscape.com/viewarticle/857533?src=soc_fb_share</ref>

Diana Phillips January 20, 2016

Disparities in end-of-life care between physicians and the general patient population suggest a gap between what physicians choose for themselves and the care provided to most patients.

New research examining the intensity of end-of-life care and the locations of death for physicians and nonphysicians indicate that physicians receive less aggressive care before death. They are also less likely to die in the hospital and are more likely to receive hospice care than similar nonphysician patients.

The findings, reported in two research letters published January 19 in JAMA, may add credence to the view expressed by some experts that physicians die in a manner that is more consistent with their end-of-life preferences than does the general population.

In one of the studies, Joel S. Weissman, PhD, from the Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts, and colleagues examined whether physicians receive higher- or lower-intensity end-of-life treatments compared with nonphysicians.

The investigators analyzed end-of-life resource use among Medicare beneficiaries across four states who died between 2004 and 2011. Looking specifically at measures of surgery, hospice care, intensive care unit admission, in-hospital death, and expenditures during the last 6 months of life, they compared outcomes among physicians (2396), lawyers (2081), and the general population (665,579).

In adjusted analyses, physicians were significantly less likely to die in a hospital compared with the general population (27.9% vs 32.0%; P < .001). They were also significantly less likely to have surgery (25.1% vs 27.4%; P = .01) and less likely to be admitted to the intensive care unit (25.8% vs 27.6%; P = .04).
Compared with lawyers, who are considered socioeconomically and educationally similar, physicians were significantly less likely to die in a hospital (27.9% vs 32.7%; P < .001). Physicians and lawyers did not differ, however, on other measures of care.

Although moderate, the differences for three of the five end-of-life care intensity measures "suggest less aggressive care for physicians," the authors write. They note that physicians' insight into the "burdens and futility" of intense end-of-life care, "as well as the benefits and the financial resources to pay for other treatment options" may partially explain the difference.

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