He said the goal of the report was to promote palliative care, which aims to minimize patient suffering and promote quality of life, but is not covered as comprehensively as hospital care by the government private insurers. Medicare covers hospice services but requires patients who choose that option to then forgo most hospital treatment.
Federal officials are offering three-year grants to 15 hospice programs nationwide to serve patients without requiring them to give up hospital treatment.
Dr. Tom Rosenthal, chief medical officer for the UCLA Health System, said the study raises important questions about how doctors manage end-of-life care. The five UC hospitals recently joined Cedars-Sinai in an effort to standardize palliative-care programs and provide patient educators to explain intensive care and other end-of-life options. The project will be paid for by a three-year, $9.9-million federal stimulus grant.
"There really are nationally no norms for end-of-life treatment," Rosenthal said, but he cautioned that comparisons among hospitals are complicated by their mix of patients. "The people who want to die peacefully at home are not the patients pressuring their doctors to send them to a major urban care center."
Cheryl Stratos, 46, of McLean, Va., flies across the country each month to participate in a clinical trial at UCLA's Jonsson Comprehensive Cancer Center in Westwood to treat her metastatic melanoma.
Stratos, who runs a marketing firm and has a 13-year-old son, said she is not sure whether she would want life-sustaining treatment — her energy has been focused on seeking care, first at Georgetown University Hospital, then Memorial Sloan-Kettering Cancer Center in New York City and UCLA.
"It all depends on where I am in the process," she said.