The Article in Brief
Regional Variation in Primary Care Involvement at the End of Life
Andrew W. Bazemore , and colleagues
Background Primary care improves patient care through coordination of care and services, continuity of relationships, and comprehensiveness of practice, but more information is needed about primary care physician (PCP) participation in end of life care. This study examines regional variation in PCP involvement in the end of life and the association of such involvement with end of life outcomes.
What This Study Found Regions of the country with greater primary care physician involvement in the last 6 months of life have lower-intensity, lower-cost end-of-life care. Chronically ill adults in regions with greater primary care physician involvement have less care in the intensive care unit in their last 6 months of life and are less likely to have more than 10 physicians in their care. These regions also have less costly end-of-life care, despite lower rates of hospice use.
Implications
- These findings can help us better understand and optimize the role of primary care physicians in care at the end of life in order to both improve the care of the dying and reduce unnecessary and costly intensive care.