Health Affairs

Health Affairs, 28, no. 5 (2009): 1357-1359 doi: 10.1377/hlthaff.28.5.1357 © 2009 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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Perspectives

PERSPECTIVE

Opportunities To Improve The Quality Of Care For Advanced Illness

Randall Krakauer, Claire M. Spettell, Lonny Reisman and Marcia J. Wade

Many studies describe a sizable chasm between the care Americans consider optimal for advanced illness and what we actually experience. Aggressive or curative measures may be pursued to the exclusion of comfort, pain relief, and psychosocial support. We briefly describe a care management program that gives people culturally sensitive supportive information, to make informed choices and obtain palliative services in a timely manner. In the sample population, more members chose hospice care; acute care utilization declined. It is possible to assist Americans with advanced illness and remove barriers to selecting hospice care, if that is their choice, without adverse financial impact.

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