h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

Strapped US Health Care System Fails to Address Actual Health Needs

More than half of US health care dollars are spent to treat individuals with chronic health conditions according to a recent report from Johns Hopkins reported by the Caregiving Resource Center. Chronic conditions are defined as conditions that last a year or longer, limit what one can do and/or may require ongoing medical care.

Some 60 million people live with chronic conditions and the number only increases as the population ages. Even though the bulk of health care dollars is going to individuals with chronic conditions, these same individuals pay five times more out-of-pocket than individuals without chronic conditions - regardless of the type of insurance they have. Medicare beneficiaries typically pay the most out-of-pocket expenses despite two-thirds of Medicare spending is on behalf of people with five or more chronic conditions.

The US health care system is organized to treat acute episodes of illness. However, many illnesses that once could not be effectively treated, resulting in episodes of acute crisis, can now be managed in a way that enables patients to live for years with a serious disease. Chronic conditions require management specifically geared to avoiding or limiting acute episodes and enhancing day to day functioning. Our health care system is not designed to effectively manage chronic conditions, and insurance reimbursement is not structured to compensate for these new treatment requirements. With government dollars for health care shrinking significantly, these scarce resources need to be more effectively managed. If steps are not taken to make the system respond more rationally to the actual needs of patients, the current health care crisis will only deepen more rapidly.

To view the article and link to the report go to:


http://click.topica.com/maaaNcCaaVwvya4yZIBe/

Study Finds Significant Misunderstandings About Patients' Living Wills

A recent study reported in the American Journal of Respiratory and Critical Care Medicine found that doctors, family members and patients do not necessarily share an understanding of what is meant by "terminal" or under what circumstances patients do or do not want certain treatment interventions.

The meaning of "terminal" is ambiguous. Some interpret it as meaning 0% chance for survival, while to others it may mean a slight chance or even as high as a 50% chance for survival. Sometimes it is defined as being unlikely to survive for 6 months and sometimes terminal may mean unlikely to survive for more than one-year. Advance directive laws define it differently from state to state, individual physicians have their own personal definitions, and patients, health care agents and family members also may interpret it differently.

This study found wide variation among patients, family members and physicians regarding their understanding of the meaning of terminal when applied to individual patients' living wills. This confusion could lead to over treatment for some patients, but under treatment for others.

This study is yet another illustration of why patients, families and health care providers must talk to each other. Just having an advance directive is not enough to avoid false assumptions. Further discussion is needed.

To view the study go to


http://click.topica.com/maaaNcCaaVwvAa4yZIBe/
http://click.topica.com/maaaNcCaaVwvCa4yZIBe/

I had a horrid experience with my Mothers choices in her last illness and her end of life times More needs to be done. I think more individual choice and compassion for the dying is in order.In the end it is still up to the Dr. wishes and beliefs NOT the patients in most cases.

How odd I put this in my journal and the next day up popped convos on the topic teehee ~good weird tho

Yes, I actually had a very good lurk round your space yesterday (tee-hee, I was there all the time but you couldn't see me!)

very unfair, but I didn't want to talk, but still wanted to feel involved.

There's been a lot in the news about it here, 'cos a nurse is being done for murder; she claims they (at least 9 cases)were mercy killings.

I don't know what to think; my mother was in a coma when pregnant with me, supposedly brain-dead; I was supposed to have been aborted. Then she astounded them all by coming out of it; turned out she'd not had polio as supposed, but "parrot's disease"; psittacosis.

And here I am! I certainly wouldn't want to live as a vegetable though, neither would & we've discussed it. Say no more. (we don't talk about Harley)

Terri

Terri said~~"very unfair, but I didn't want to talk, but still wanted to feel involved"
NO NO it is not

It is important to talk about your wishes~~thats good!

I am glad to hear you *eased back in* sounds healthy! ~~good 4 U!

After the unpleasant experience with the you-know-who's; I just felt so that it had resulted in me & ending up arguing; I wanted nothing more to do with it. persuaded me, reckons I need the input & a healthy dose of English speaking (mind you, think he's getting hooked himself too!!)

About to put a link in my link bit to Wowbagger, if you've not seen them, they're brilliant cartoons about hootoo life, great for when it's a bit quiet or you feel like a change from heavy discussions!

zdt

Wow that sounds like fun! I will follow that link. Thanks Terri.