The National Palliative Care Research Center

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The Care of Patients with Severe Chronic Illness: A Report on the Medicare Program by the Dartmouth Atlas Projec

04.06.2006

The Care of Patients with Severe Chronic Illness: A Report on the Medicare Program by the Dartmouth Atlas Project, an online report on differences in the management of Medicare enrollees with severe chronic illnesses, was released Tuesday, May 16, 2006. The focus of the new study is the care of Medicare beneficiaries with one or more of twelve chronic illnesses that accounts for more than 75% of all U.S. health care expenditures. Among people who died between 1999 and 2003, per capita spending varied by a factor of six between hospitals across the country.Average utilization and spending varied from state to state, from region to region within states, and from hospital to hospital within the same regions.Spending was not correlated with rates of illness in different parts of the country; rather, it reflected how intensively certain resources - acute care hospital beds, specialist physician visits, tests and other services - were used in the management of people who were very ill but could not be cured. Since other research has demonstrated that, for these chronically ill Americans, receiving more services does not result in improved outcomes, and since most Americans say they prefer to avoid a very "high-tech" death, the report concludes that Medicare spending for the care of the chronically ill could be reduced by as much as 30% -while improving quality, patient satisfaction, and outcomes More information...