Arch Intern Med 14 Feb 2011 Vol 171
196 Miriam Johnson and Richard Lehman compiled the first book on Heart Failure and Palliative Care five years ago, aimed mainly at a UK audience. It's not known if it's sold any copies in the USA, but a new survey of resource use in the last 6 months of life among Medicare beneficiaries with heart failure shows a huge rise in hospice use by these patients between the beginning of 2000 and the end of 2007. The official Medicare policy remains to distinguish between "palliative" and "curative" treatments, but it is good to see that such distinctions seem to be little heeded in this group, who have also been given more intensive medical treatment as well. It had been hoped to say goodbye forever to this gloomy subject, but the need to identify patient-important symptomatic outcomes in heart failure remains huge, as does the need to provide better end-of-life care: so there maybe more to write about this matter
http://archinte.ama-assn.org/cgi/content/abstract/171/3/196
211 The Canadian health system is very different, but the same trends can be observed there too. Hospital admissions in the last 6 months of HF are decreasing, but costs are increasing. Commissioners take note: there are no cheap ways of helping heart failure patients to live longer, or die better.
http://archinte.ama-assn.org/cgi/content/abstract/171/3/211
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