RxPG News Feed for RxPG News

Medical Research Health Special Topics World
  Home
 
   Health
 Aging
 Asian Health
 Events
 Fitness
 Food & Nutrition
 Happiness
 Men's Health
 Mental Health
 Occupational Health
 Parenting
 Public Health
 Sleep Hygiene
 Women's Health
 
   Healthcare
 Africa
 Australia
 Canada Healthcare
 China Healthcare
 India Healthcare
 New Zealand
 South Africa
 UK
 USA
 World Healthcare
 
   Latest Research
 Aging
 Alternative Medicine
 Anaethesia
  Resuscitation
 Biochemistry
 Biotechnology
 Cancer
 Cardiology
 Clinical Trials
 Cytology
 Dental
 Dermatology
 Embryology
 Endocrinology
 ENT
 Environment
 Epidemiology
 Gastroenterology
 Genetics
 Gynaecology
 Haematology
 Immunology
 Infectious Diseases
 Medicine
 Metabolism
 Microbiology
 Musculoskeletal
 Nephrology
 Neurosciences
 Obstetrics
 Ophthalmology
 Orthopedics
 Paediatrics
 Pathology
 Pharmacology
 Physiology
 Physiotherapy
 Psychiatry
 Radiology
 Rheumatology
 Sports Medicine
 Surgery
 Toxicology
 Urology
 
   Medical News
 Awards & Prizes
 Epidemics
 Launch
 Opinion
 Professionals
 
   Special Topics
 Ethics
 Euthanasia
 Evolution
 Feature
 Odd Medical News
 Climate

Last Updated: Oct 11, 2012 - 10:22:56 PM
Resuscitation Channel

subscribe to Resuscitation newsletter
Latest Research : Anaethesia : Resuscitation

   EMAIL   |   PRINT
Hospital characteristics play a role in use of do-not-resuscitate orders

Aug 10, 2005 - 1:13:00 PM
"The initiation of end-of-life discussions and the implementation of DNR orders are important toward ensuring that patients receive care appropriate to their prognosis and preferences,"

 
[RxPG] Hospital characteristics, including size, non-profit status and affiliation with a university, appear to be associated with use of do-not-resuscitate orders (DNR) in California, independent of the patient's characteristics, according to a study in the August 8/22 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.

Do-not-resuscitate orders are essential for guiding the care provided to hospitalized patients, according to background information in the article. Treatments like resuscitation may be inappropriate or may afford short-term benefits without achieving valued long-term goals. If DNR orders reflect patients' preferences and guide care that is consistent with these preferences, DNR orders can be considered indicators of the quality of health care at an institution, the authors suggest.

David S. Zingmond, M.D., Ph.D., and Neil S. Wenger, M.D., M.P.H., of The David Geffen School of Medicine at UCLA, Los Angeles, analyzed records from California hospitals to determine whether institutional factors were associated with the use of DNR orders. The researchers assessed the association between hospital characteristics, (size, profit status and academic status) and the use of a DNR order written within the first 24 hours of admission. The researchers also assessed whether there were regional differences in the use of DNR orders. Of approximately one and half million patients 50 or older admitted for acute care during 2000, the researchers included in their analysis 819,686 admissions at 386 California hospitals for 40 of the most common medical and surgical/procedural diagnoses-related groups (DRGs).

The researchers found that the percentage of DNR orders written within the first 24 hours of admission varied from two percent for patients aged 50-59 years to 17 percent for patients 80 years or older. The odds of having early DNR orders written were significantly lower in for-profit vs. private non-profit hospitals, were higher in the smallest vs. the largest hospitals, and were lower in academic vs. non-academic institutions. The rate of DNR order use varied by 10-fold depending on region with the highest rates in rural areas, the authors report.

"The initiation of end-of-life discussions and the implementation of DNR orders are important toward ensuring that patients receive care appropriate to their prognosis and preferences," the authors conclude. "Hospital characteristics appear to be associated with the use of DNR orders, even after accounting for differences in patient characteristics. This association reflects institutional culture, technological bent, and physician practice patterns."



Publication: August 8/22 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals
On the web: Arch Intern Med. 2005;165:1705-1712 

Advertise in this space for $10 per month. Contact us today.


Related Resuscitation News
Hospital characteristics play a role in use of do-not-resuscitate orders

Subscribe to Resuscitation Newsletter

Enter your email address:


 Feedback
For any corrections of factual information, to contact the editors or to send any medical news or health news press releases, use feedback form

Top of Page

 
Contact us

RxPG Online

Nerve

 

    Full Text RSS

© All rights reserved by RxPG Medical Solutions Private Limited (India)