How Texas Cities Rank on End-of-Life Care

Want to die comfortably? Move to Corpus Christi. A study of national hospice and hospitalization trends shows the percentage of Medicare patients dying in hospitals there, as opposed to at home or in hospice, is dropping fast. 

As Texas lawmakers debate how to handle end-of-life care, health care experts are seeking ways to keep patients more comfortable, and contain costs, in their final weeks or months. In general, both the percentage of Medicare patients dying in hospitals and the number of days they spent in the hospital prior to their deaths are dropping — though the statistics vary widely by region. 

Among the findings of the Dartmouth Institute for Health Policy and Clinical Practice's new report, "Trends and Variation in End-of-Life Care for Medicare Beneficiaries with Severe Chronic Illness:"

— The percentage of chronically ill Medicare patients dying in a hospital fell by 14 points in Corpus Christi between 2003 and 2007, the second biggest drop in the country. But in Amarillo, the percentage of patients dying in a hospital grew by 4.5 points, the second biggest increase in the nation. 

— In that same time period, the number of days the average Corpus Christi Medicare patient spent in the hospital during the last six months of life dropped by four days, the biggest decline in the country.

— In McAllen in 2007, 30.4 percent of chronically ill Medicare patients were admitted to intensive care during their final hospital admission, the second-highest rate in the country.

— Between 2003 and 2007, the average number of days a patient spent in hospice care in the final six months of life grew most dramatically in Wichita Falls, where it rose by nearly 18 days. In 2007, Lubbock patients in the final six months of life spent the second-highest number of days in hospice — just over 35 days. 

According to the report, about a quarter of all Medicare spending pays for patients in their final year of life. Its authors suggest it could be possible to curb spending while also improving the quality of end-of-life care.