Medicare patient hospital days down, but intensity up

Medicare patients in whom severe chronic illness was diagnosed in 2007 were less likely to die in a hospital than in 2003 and more likely to receive hospice care, but they had many more visits from physicians, particularly specialists, and spent more days in intensive care units, according to a Dartmouth Atlas Project report on trends and variation in end-of-life care.

In 2003, 32.2% of patients died in a hospital; by 2007, the rate had dropped to 28.1%. Overall, the average patient spent slightly fewer days in the hospital during the last 6 months of life in 2007 than in 2003, as the national rate dropped from 11.3 to 10.9 hospital days per patient.

Overall, chronically ill patients were significantly more likely to be treated by 10 or more doctors in the last 6 months of life in 2007 than they were in 2003, as the national rate increased from 30.8% to 36.1%.