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Physicians more likely to use hospice, ICU care at end of life

Compared with the general population, physicians in the United States were more likely to use hospice, ICU care or critical care unit in the last months of their lives, according to research published in the Journal of the American Geriatrics Society.

Daniel D. Matlock, MD, MPH, from the University of Colorado Division of Geriatrics, and colleagues, also found that hospitalization rates between the two groups were similar.

"Because physicians are intimately familiar with the health care arena, they are uniquely aware of potential benefits and limitations of modern medicine," they wrote. "Their medical knowledge allows for a better understanding of prognosis. As a consequence, it was hypothesized that physicians would approach their own death and dying differently than someone without the same level of understanding and experience."

The researchers conducted a retrospective observational cohort study of 9,947 decedent physicians and 192,006 Medicare decedents, all of whom were fee-for-service Medicare beneficiaries. They used Medicare Part A claims data from 2008 to 2010 to assess hospitalization time and hospice use in the last 6 months of life.

Results showed inpatient hospital use and deaths in the hospital did not differ between physicians and the general population. Physicians were more likely to use hospice, with 46.4% of physicians and 43.2% of nonphysicians (P < .001) enrolled in hospice care during the last 6 months of life. They also spent a mean difference of 0.35 more days in the ICU or critical care unit (P < .001).

Matlock and colleagues wrote that, despite media reports that physicians die differently than other Americans, their findings suggest subtler differences.

"Doctors may be more likely to die using hospice, but they are no less likely to use high-intensity hospital care," they concluded. "If anything, they have higher rates of ICU use in the last 6 months of life. Society as a whole and policy-makers focused on containing health care costs in particular may be surprised to learn that even physicians, with knowledge of and experience with death and dying, have use of hospitals nearly identical to that of nonphysicians." – by Chelsea Frajerman Pardes

Disclosures: The researchers report no relevant financial disclosures.