Patient-Physician End-of-Life Discussions in the Routine Care of Medicare Beneficiaries.
Patient-Physician End-of-Life Discussions in the Routine Care of Medicare Beneficiaries.
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DOI：
10.1177/0898264315569458
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发表时间：
2015-09
影响因子：
2.8
通讯作者：
Moorman SM
中科院分区：
文献类型：
--
作者：
Keary S;Moorman SM
2010年《平价医疗法案》削减了对在办公室访问期间与患者讨论临终护理和计划的医生的医疗保险报销。我们评估了报告有过此类讨论的患者的特征，以及这些讨论是否与对医生的信任和家庭预先护理计划（FACP）的比率相关。该样本包括5，199名医疗保险受益人，他们报告与初级保健医生有持续的关系。我们估计有序和多项式逻辑回归控制医疗保健利用，目前的健康状况，和最近的家庭死亡。不到1%（n = 310）的患者报告在常规护理过程中与医生进行了临终交谈。然而，谈话与对医生的更大信任和更高的FACP完成率相关。研究结果支持重新努力偿还医生与他们的医疗保险病人讨论生命结束。
Medicare reimbursement for physicians who discussed endof-life care and planning with a patient during an office visit was cut from the 2010 Affordable Care Act. We assessed the characteristics of patients who reported having had such discussions, and whether these discussions are associated with trust in one’s physicians and with rates of family advance care planning (FACP). The sample consisted of 5,199 Medicare beneficiaries who reported having an ongoing relationship with a primary care physician. We estimated ordinal and multinomial logistic regressions that controlled for health care utilization, current health, and recent family deaths. Less than 1% (n = 310) reported an endof-life conversation with a physician during the course of routine care. However, conversations were associated with greater trust in one’s physician and higher rates of completion of FACP. Findings support renewed efforts to reimburse physicians for discussing end of life with their Medicare patients.
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影响因子：
1.9
作者：
Lee, Yin-Yang;Lin, Julia L.
通讯作者：
Lin, Julia L.
影响因子：
120.7
作者：
Mechanic, D;Schlesinger, M
通讯作者：
Schlesinger, M
影响因子：
2
作者：
Carr, Deborah
通讯作者：
Carr, Deborah
影响因子：
5.7
作者：
Carr, Deborah
通讯作者：
Carr, Deborah
影响因子：
39.2
作者：
Mack, Jennifer W.;Cronin, Angel;Weeks, Jane C.
通讯作者：
Weeks, Jane C.