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Advance Directives Might Curb Cost of End-of-Life Care
Date:10/5/2011

By Serena Gordon
HealthDay Reporter

TUESDAY, Oct. 4 (HealthDay News) -- Depending on where you live, having an advance directive may raise the odds that you'll receive hospice services and reduce the overall cost of your end-of-life care, a new study indicates.

An advance directive, sometimes called a living will, is a legal document that expresses your wishes for the type of care you would like to receive should you become unable to make such decisions yourself.

"The most important finding from our study is the evidence that advance directives can be very important in shaping the care that's provided to patients," said study author Lauren Hersch Nicholas, a health economist at the Institute for Social Research at the University of Michigan, in Ann Arbor.

The findings are published in the Oct. 5 issue of the Journal of the American Medical Association.

End-of-life care is often a controversial subject, and when policymakers are looking for ways to control Medicare costs, such care typically comes up in the discussion. That's not surprising, because end-of-life care accounted for more than one-quarter of Medicare spending last year, according to background information in the study. One concern is that this spending may be largely earmarked for aggressive care that's not necessarily what the patient might have wanted.

And, that's where advance directives can be useful. They allow patients to document their wishes, whether they want all life-sustaining measures to be taken or if they'd prefer to avoid such procedures.

The study authors noted that there's also a wide variation in the amount spent on end-of-life care, depending on the area you live in the United States. For example, according to 2003-2007 data from the Dartmouth Atlas of Health Care, regions such as the more densely populated areas of the Northeast, Texas and California spend much more on caring for people in their
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