Surgery common among elderly Medicare patients at end of life

Nearly one-third of elderly Americans covered by Medicare have surgery in their last year of life—especially in the last month or final week of life—that often is unnecessary, unwanted by the patient, and may be influenced by financial interests of the health system, according to a new study led by Harvard School of Public Health (HSPH) researchers.

The rate at which these surgeries occur varies by where patients live, their age, and access to hospital beds, the authors reported. The study, “The Intensity and Variation of Surgical Care at the End of Life: A Retrospective Cohort Study,” was published October 6, 2011, in Online First in The Lancet.

“This level of surgical intensity doesn’t seem to be having much in the way of benefit for the population,” HSPH’s Ashish Jha told the New York Times. “Our sense is that there are probably lots of unnecessary procedures that go on at end of life.”

However, Jha admits these are complex matters. “A lot of physicians struggle to talk about prognosis, whether people are going to live or die. Instead they focus on trying to make little things better,” he told ABC News.

Read the abstract

Learn more

Read the New York Times article

Read ABC News coverage