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• W4232802893 abstract "Nobody wants to talk about the end of life. But conversations between physicians and their patients are essential to providing the best possible quality of health care at all stages of life. On July 8, Medicare, the largest insurer in the USA of people aged 65 years and older, announced plans to cover advance care planning. This initiative will reimburse doctors for counselling patients about end-of-life care before they become physically or mentally incapable of making decisions.In 2014, the Institute of Medicine emphasised the urgent need for improvement in the quality of end-of-life care in their report, Dying in America. Among the challenges to the provision of high-quality care it identified were inadequate access to services for disadvantaged populations and a poor understanding of palliative care among health professionals. The report recommended that end-of-life care be delivered in an integrated, person-centred, family-oriented manner, and be covered by both government and private insurers. Many of the problems identified in the report are not limited to the USA, and inadequacies in global access to palliative care and pain control are the focus of an ongoing Lancet Commission.Having these difficult conversations is crucial to ensure that all patients are treated with dignity and that treatment, whether palliative or curative, fits within their wishes. The advance care planning measures proposed by Medicare will enable patients to make better informed and better supported decisions about end-of-life care. Many physicians already provide counselling as part of routine health care for terminally ill patients and some private insurers already offer coverage for advance care planning. By reimbursing physicians for time spent counselling patients, Medicare recognises the importance of end-of-life care as part of an integrated health care system.It is time to open up the conversation about end-of-life and palliative care to ensure continuity of high-quality health care for patients at all stages of life. Preparing for the end of life is as important as preparing for its start; the new Medicare provisions should be applauded for acknowledging just that. Nobody wants to talk about the end of life. But conversations between physicians and their patients are essential to providing the best possible quality of health care at all stages of life. On July 8, Medicare, the largest insurer in the USA of people aged 65 years and older, announced plans to cover advance care planning. This initiative will reimburse doctors for counselling patients about end-of-life care before they become physically or mentally incapable of making decisions. In 2014, the Institute of Medicine emphasised the urgent need for improvement in the quality of end-of-life care in their report, Dying in America. Among the challenges to the provision of high-quality care it identified were inadequate access to services for disadvantaged populations and a poor understanding of palliative care among health professionals. The report recommended that end-of-life care be delivered in an integrated, person-centred, family-oriented manner, and be covered by both government and private insurers. Many of the problems identified in the report are not limited to the USA, and inadequacies in global access to palliative care and pain control are the focus of an ongoing Lancet Commission. Having these difficult conversations is crucial to ensure that all patients are treated with dignity and that treatment, whether palliative or curative, fits within their wishes. The advance care planning measures proposed by Medicare will enable patients to make better informed and better supported decisions about end-of-life care. Many physicians already provide counselling as part of routine health care for terminally ill patients and some private insurers already offer coverage for advance care planning. By reimbursing physicians for time spent counselling patients, Medicare recognises the importance of end-of-life care as part of an integrated health care system. It is time to open up the conversation about end-of-life and palliative care to ensure continuity of high-quality health care for patients at all stages of life. Preparing for the end of life is as important as preparing for its start; the new Medicare provisions should be applauded for acknowledging just that." @default.
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• W4232802893 date "2015-07-01" @default.
• W4232802893 modified "2023-09-25" @default.
• W4232802893 title "Medicare opens up the end-of-life conversation" @default.
• W4232802893 doi "https://doi.org/10.1016/s0140-6736(15)61262-4" @default.
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