WEDNESDAY, March 27 (HealthDay News) -- Many people are still
dying in hospitals, despite the fact that there has been a decrease
in the number of patients who spend their final days in a setting
that most would rather avoid, a new government report shows.
While the number of people admitted to U.S. hospitals increased
11 percent between 2000 and 2010, going from 31.7 million to 35.1
million, the number of people who died in hospitals dropped 8
percent, from 776,000 to 715,000, according to the U.S. Centers for
Disease Control and Prevention.
The drop in hospital deaths occurred largely among women, the
"That could just be that there were more older women who were able to be placed in alternative settings, because women live longer. That's just a hypothesis," said report author Margaret Jean Hall, from the CDC's National Center for Health Statistics (NCHS). The report was released Wednesday and published in the March NCHS Data Brief.
Overall, the in-hospital death rate is 20 percent lower for
people who die from their diagnosed disease, Hall said. For some
conditions, however, the decrease is even greater. For example, the
in-hospital death rate is down 65 percent for kidney disease, 46
percent for cancer and 27 percent for stroke, Hall noted.
"Almost all of the major reasons people [who are hospitalized die] have gone down," Hall added. "This doesn't mean they are going home or [being] cured, but they aren't dying in the hospital in as large an extent as they were in earlier years."
Because people generally prefer to die at home and not in the
hospital, "this is a good sign," Hall pointed out. "But we don't
know where they go right after leaving the hospital."
Many patients could be going to nursing homes or to long-term
care facilities, Hall suggested. "But these alternatives are less
intense and maybe closer to a setting that would be preferable to
the high-tech hospital," she explained.
The one area where the in-hospital death rate has increased
involved cases of life-threatening blood infections, jumping 17
percent from 2000 to 2010. Whether these infections developed in
the hospital isn't known because the report only deals with the
conditions patients were diagnosed with when they were admitted to
the hospital, Hall said.
Highlights of the report include:
One expert thinks the report is a good argument for better
"I think this points out several key gaps in the health care system," said Dr. R. Sean Morrison, director of the National Palliative Care Research Center at Mount Sinai School of Medicine in New York City.
One is the need for community palliative care services, he
Although palliative care teams are in place at most hospitals,
they are still not very accessible to people in the community, he
explained. "Without community palliative care, it is very hard for
seriously ill persons to receive the care they need at home,"
In addition, while insurance covers hospital care
comprehensively, the cost of the same care at home is largely borne
by patients because it is not covered by insurance, he noted.
"People want to be cared for where they feel safe," Morrison said. "If there are large gaps in coverage at home, even if they would prefer to be at home, they are likely to end up in hospital."
For more on end-of-life care, visit the
U.S. National Library of Medicine.
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