Docs, patients have different attitudes toward end-of-life care
Daniel J. Rocke, M.D., J.D., from the Duke University Medical Center in Durham, N.C., and colleagues examined data from 767 otolaryngology head and neck surgery (OHNS) physicians who used an online tool to create a Medicare health plan for patients with advanced cancer. A limited pool of resources was allocated into 15 benefit categories. The data were compared with those obtained using the same tool by 146 patients with cancer and 114 caregivers.
The researchers found that OHNS physician allocations differed significantly from those of patients and caregivers in all benefit categories except home care. On stratification by baseline attitudes toward quantity versus quality of life, there were significant differences in the allocations of patients and caregivers from the group with the opposite attitude in three categories: other medical care, palliative care, and treatment for cancer. For each attitude question, physician preferences were significantly different in only one, nonmatching category: cash, drugs, and home care.
"Patients with cancer and their caregivers have different preferences from physicians," the authors write. "These preferences are, for these patients and their caregivers, affected by their baseline health attitudes, but physician preferences are not."
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