HealthDay News — According to a study published in the Annals of Family Medicine, higher primary care physician involvement in end-of-life care is associated with less intensive and lower cost end-of-life care.

Claire Ankuda, MD, MPH, from the University of Michigan Health System in Ann Arbor, and colleagues analyzed Medicare Part B claims data for US hospital referral regions (HRRs) to examine the correlation of primary care physician involvement at the end of life with care patterns. 

Three hundred six HRRs were assessed, capturing data for 1,107,702 Medicare Part B beneficiaries with chronic disease who died.

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The researchers found that the inter-quartile range of the HRR ratio of primary care to specialist end-of-life visits was 0.77 to 1.21. Significantly different patient, population and health system characteristics were seen for HRRs with high versus low primary care physician involvement at the end of life.

HRRs with the greatest involvement of primary care physicians had significantly lower Medicare spending in the last 2 years of life ($65,160 versus $69,030), fewer intensive care unit days in the 6 months preceding death (2.90 versus 4.29) and less hospice enrollment (44.5 versus 50.4% of decedents), after adjustment for these differences.

“It is promising that areas of high primary care physician involvement appear to have lower-intensity, lower-cost care,” the authors write.


Ankuda CK, et al. “Regional Variation In Primary Care Involvement At The End Of Life”. The Annals of Family Medicine. 2017;15(1): 63-67. doi: 10.1370/afm.2002

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