TY - JOUR
T1 - Are Preferences for Aggressive Medical Treatment Associated with Healthcare Utilization in the Very Old?
AU - Albert, Steven M.
AU - Lunney, June R.
AU - Ye, Lei
AU - Boudreau, Robert
AU - Ives, DIane
AU - Satterfield, Suzanne
AU - Kaplan, Cameron M.
AU - Waters, Teresa
AU - Ayonayon, Hilsa N.
AU - Rubin, Susan M.
AU - Newman, Anne B.
AU - Harris, Tamara
N1 - Publisher Copyright:
© Copyright 2017, Mary Ann Liebert, Inc.
PY - 2017/6
Y1 - 2017/6
N2 - Objectives: To examine the relationship between end-of-life (EOL) treatment preferences and recent hospitalization or emergency department (ED) care in the very old. Design: Quarterly telephone follow-up of participants in the EOL in the Very Old cohort. Setting: The EOL in the Very Old Age cohort drew from 1403 participants in the Health, Aging, and Body Composition (Health ABC) study who were alive in year 15 of follow-up. 87.5% (n = 1227) were successfully recontacted and enrolled. Participants: Preferences for treatment at the EOL and reported hospital and ED use were examined for 1118 participants (18% involving proxy reports) over 6 months, 1021 (16% with proxy reports) over 12 months, and 945 (23% with proxy reports) over 18 months in 6-month intervals. Measurements: Preferences for eight EOL treatments, elicited once each year; hospitalization and ED use reported every six months. Results: Preferences for more aggressive treatment (endorsing ≥5 of 8 options) were not significantly associated with inpatient or ED treatment. Inpatient and ED treatment were not associated with changes in preferences for aggressive EOL treatment over 12 months. Conclusion: Alternative measures that tap attitudes toward routine care, rather than EOL treatment preferences, may be more highly associated with healthcare utilization.
AB - Objectives: To examine the relationship between end-of-life (EOL) treatment preferences and recent hospitalization or emergency department (ED) care in the very old. Design: Quarterly telephone follow-up of participants in the EOL in the Very Old cohort. Setting: The EOL in the Very Old Age cohort drew from 1403 participants in the Health, Aging, and Body Composition (Health ABC) study who were alive in year 15 of follow-up. 87.5% (n = 1227) were successfully recontacted and enrolled. Participants: Preferences for treatment at the EOL and reported hospital and ED use were examined for 1118 participants (18% involving proxy reports) over 6 months, 1021 (16% with proxy reports) over 12 months, and 945 (23% with proxy reports) over 18 months in 6-month intervals. Measurements: Preferences for eight EOL treatments, elicited once each year; hospitalization and ED use reported every six months. Results: Preferences for more aggressive treatment (endorsing ≥5 of 8 options) were not significantly associated with inpatient or ED treatment. Inpatient and ED treatment were not associated with changes in preferences for aggressive EOL treatment over 12 months. Conclusion: Alternative measures that tap attitudes toward routine care, rather than EOL treatment preferences, may be more highly associated with healthcare utilization.
KW - Cohort studies
KW - End-of-life
KW - Health ABC
KW - Healthcare utilization
KW - Treatment preferences
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U2 - 10.1089/jpm.2016.0284
DO - 10.1089/jpm.2016.0284
M3 - Article
C2 - 28333569
AN - SCOPUS:85019738057
SN - 1096-6218
VL - 20
SP - 618
EP - 624
JO - Journal of Palliative Medicine
JF - Journal of Palliative Medicine
IS - 6
ER -