News in brief - Oct. 10, 2011

Study details care of dementia patients near death

About one in five nursing home patients with dementia is unnecessarily hospitalized or transferred in the last days of life, according to a study of nearly half a million Medicare patients published Sept. 29 in The New England Journal of Medicine (www.nejm.org/doi/full/10.1056/nejmsa1100347).

Nearly 20% of these patients experienced multiple hospitalizations in the last three months of their lives, were transferred to a different nursing home after hospitalization or were transferred in the three days before they died. The patients who saw the most transfers at the end of their lives were much likelier to be tube-fed, spend time in an intensive care unit, have a serious bedsore or enroll late in hospice. The study authors said that much of this high-intensity care at the end of life is unneeded, but is encouraged by financial incentives. For patients on Medicaid, nursing homes can get paid three to four times more for providing postacute care under Medicare Part A, said an accompanying NEJM editorial (www.nejm.org/doi/full/10.1056/nejmp1105449).

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National Quality Forum unveils quality-measure search engine

The National Quality Forum launched a website to help physicians and other quality improvement leaders use its performance measures. The tool -- the Quality Positioning System -- allows users to search for relevant measures and save them in an online portfolio for later use. The forum is a Washington-based nonprofit whose quality standards are widely used by payers and health care organizations to gauge performance in many areas of care.

Consumer organizations, payers, physicians, nurses, hospitals, accreditation bodies, health researchers and quality improvement organizations participate in the forum's standards-setting process. The Quality Positioning System is available on the forum's website (www.qualityforum.org/qps).

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