Quality vs Quantity of Life and Futile Care in America

June 6, 2023
Quality of Life
4 min
Dr. Michael Madison, CEO

Futile care refers to medical interventions or treatments that are unlikely to benefit the patient but are still provided by healthcare providers. This often happens at the end of life, where patients are subjected to painful and invasive treatments that offer little hope for recovery. This can lead to prolonged suffering, as well as emotional and financial strain on patients and their families. Futile care is a controversial topic in healthcare, as it raises ethical questions about the role of physicians in end-of-life decision-making and the allocation of medical resources. Advance care planning can play a crucial role in reducing the occurrence of futile care by helping patients and their families make informed decisions about end-of-life care and by encouraging open communication between patients, families, and healthcare providers.

To be certain, there is limited data on the prevalence of futile care in America due to the subjective nature of the concept. However, here are some statistics related to end-of-life care in America that may paint the picture around futile care:

  • In a study published in the Journal of the American Medical Association, it was found that almost 30% of Medicare expenses were incurred in the last year of patients’ lives.
  • According to the National Hospice and Palliative Care Organization, more than 50% of deaths in the US occur in acute care hospitals, where patients are more likely to receive aggressive and costly medical interventions.
  • A study published in the Journal of Palliative Medicine found that 40% of patients with advanced cancer received aggressive treatment in the last 30 days of life, and 20% received invasive procedures such as mechanical ventilation and feeding tubes.
  • A survey conducted by the California HealthCare Foundation found that 80% of Californians would prefer to die at home, yet only 20% actually do so.
  • According to a survey by The Conversation Project, 90% of people say that talking with loved ones about end-of-life care is important, yet only 27% have actually had such conversations.
  • Another survey by the National Hospice and Palliative Care Organization found that 90% of Americans think it is important to discuss end-of-life care with their loved ones, but only 27% have actually done so.
  • In a study published in JAMA Internal Medicine, it was found that patients who received palliative care earlier had lower healthcare costs than those who received palliative care later or not at all.

While these statistics do not directly measure futile care, they do suggest that many Americans receive aggressive and costly end-of-life care that may not align with their values and preferences. Advance care planning can help address this issue by ensuring that patients receive care that is consistent with their goals and values, reducing the likelihood of receiving futile care.