Dr. Ezekiel Emanuel: End-of-life care not improving fast enough

Although end-of-life care quality has improved since 2000, with a recent study finding fewer patients are dying in hospitals and more are dying at home, Ezekiel Emanuel, MD and PhD, told Medscape Medical News progress isn't coming fast enough.

Dr. Emanuel responded to the study in an accompanying editorial and said the findings on end-of-life care were good.

"It is also much better than it was 35 years ago when research on how to improve end-of-life care was just beginning," Dr. Emanuel wrote.

But "there are still too many hospitalizations at the end of life. We need to make end-of-life care easier to use."

End-of-life care should start sooner, Dr. Emanuel suggests.

"We need to be willing to acknowledge six or 12 months beforehand that a patient is not doing well and that death is going to happen," he said. "For 30 years we have focused on the last month or last few months of life. We need to broaden that out to the last six to 12 months and begin interventions earlier."

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