Research Probes Surgery on Elders in Their Last Years of Life

Abstract

End-of-life surgical care among the elderly varies by how much older than 65 years they are and by where in the United States they are, recent research has shown. Studies “have shown a strong association between Medicare costs and regional characteristics, including number of hospital beds or specialist physicians per head (Ann. Intern. Med. 2003;138:273-87; Ann. Intern. Med. 2003;138:288-98). These data suggest that some hospital admissions could be discretionary or avoidable and some high-intensity treatments could be unnecessary or discordant with patients’ preferences,” Dr. Amy S. Kelley, a member of the faculty at Brookdale Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York City, wrote in a commentary in The Lancet (Lancet 2011;378:1364-65). Dr. Kelley was responding to a report that almost one-third of the elderly Medicare fee-for-service benefi ciaries who died in 2008 underwent surgery within one year of their death, according to a retrospective study.