Entries in Annals of Internal Medicine (2)


Making Surrogate Treatment Decisions Can Take Its Toll

Photo Courtesy - Getty Images(BETHESDA, Md.) -- When crisis strikes and a person is no longer able to make their own medical decisions, spouses, adult children, siblings and others find themselves in the role of surrogate decision-makers, trying to make the best, yet often difficult, decisions for their loved ones.  Studies have shown that the critical role of the surrogate decision-maker can be incredibly stressful.

For the first time, a study has systematically examined on a large scale the psychological after-effects of decision making on surrogates.  Researchers at the National Institute of Health reviewed 40 published articles providing data on 2,832 surrogates who were surveyed several months to years after making treatment decisions, including end-of-life decisions.

At least one-third of the surrogates experienced negative effects including stress and anxiety, and these effects were often substantial and lasted for months or years. But surrogates that knew the patient’s wishes – if, for example, the patient had a living will – suffered less stress than surrogates acting without advance directive.

The findings were published in the Annals of Internal Medicine.

Copyright 2011 ABC News Radio


High-Volume Hospitals Provide Better Care, But at a Greater Cost

Photo Courtesy - Getty Images(BOSTON) -- The most common reason for hospitalization in the Medicare program is congestive heart failure, according to

By reviewing the records of over one million patients at over 4,000 hospitals in the U.S., authors of a study at the Harvard School of Public Health found that Medicare patients with congestive heart failure in high-volume hospitals had lower death rates. But their cost of care was higher than for patients at low-volume hospitals. 

The study, published Monday in the Annals of Internal Medicine, concluded that understanding which practices employed by high-volume institutions account for such advantages -- like better care and lower mortality rates -- could help to improve quality of care and clinical outcomes for all patients with congestive heart failure.

Copyright 2011 ABC News Radio

ABC News Radio