Background: Aggressive EOL treatments in advanced cancer patients are associated with low-value care and frequently lead to unnecessary hospitalizations. Since 2012, the National Quality Forum (NQF), American Society of Clinical Oncology (ASCO), and Centers for Medicare and Medicaid Services (CMS) have adopted EOL quality measures to reduce aggressive care. Using these measures, we conducted a [...]

Background: While Medicare data demonstrates that healthcare spending is up to four times higher in yearly decedents than survivors, studies demonstrate that early advance care planning (ACP) leads to improved clinical outcomes and reduces cost without increase in patient anxiety or depression. Nationwide the creation of the Physician Order for Life Sustaining Treatment (POLST), a [...]

Background: Increasing number of palliative care patients are cared for by hospitalists, but the value of hospitalist on end-of-life (EOL) care is scarcely reported. The study aims to evaluate the effect of hospitalist care on the intensive care utilization and medical expenditure for end-of-life hospitalizations. Methods: A three-year retrospective observational study was conducted at a [...]

Case Presentation: The patient is a 74 year old woman with past history of dementia and an aggressive right upper lobe cavitary mass who presented with post-obstructive pneumonia. The lung mass was diagnosed two years prior, however, the patient refused further workup. The patient named her two daughters to be dual healthcare powers of attorney [...]