Agressive treatment could cause illness

When you have heart failure, cancer, or another type of long-term, life-threatening illness, it is hard to find the right type of care. Nancy Metcalf, of Consumer Reports, reviewed studies, including a Dartmouth study of almost five million Medicare patients who were in their last two years of life. Metcalf found that, across the nation, the most aggressive care is not necessarily delivering better results.

"Patients who have the most tests, the most procedures, see the most doctors...spend the most time in the hospital...don't do any better in the long run and they don't even live any longer than people who get more conservative treatment," said Nancy Metcalf, Consumer Reports.

Almost 3,000 hospitals were rated in the Dartmouth study. The one hospital with some of the most conservative care was Scott & White Hospital in Temple, Texas.

In the last two years of life, patients at Scott & White spent less time in the hospital and less time on doctor payments. According to Medicare's ratings on a variety of quality measures, care was considered very good.

In Los Angeles County, City of Hope Medical Center had similar results. City of Hope was rated among larger hospitals in the Dartmouth study.

"Aggressive care can actually lead to poorer results. The more tests and procedures you have, the greater your risk of infections and other complications. And the more medical specialists you see, the greater your risk of medical errors because of poorly coordinated care," said Metcalf.

Consumer Reports says for the best medical care, you should rely on a single doctor to coordinate treatment. If several doctors are involved, call for a meeting to discuss your case. Always ask about the risks, as well as the benefits of any test or treatment.

For serious chronic illnesses, hospitals vary in the aggressiveness of their care. Experts say patients should research what type of care to expect at each hospital.


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