FORBES | For loved ones with advanced illness such as cancer or heart disease or with severe symptoms from a chronic illness, especially in the last year or so of life, what we desperately want is for them to seamlessly receive high quality, compassionate care at home that keeps them comfortable and free from pain and suffering.
Unfortunately, that is extremely rare today.
Too often, patients with a serious illness find themselves in and out of emergency rooms and hospitals, juggling a confusing array of medicines prescribed by different physicians, chaotically bouncing back and forth to doctors’ offices, on average 29 times in the last 6 months of life. This is not for lack of dedicated clinicians or even a lack of insurance. No, it is explained mostly by the historical anomaly whereby our American health care system has evolved on a rigid fee-for-service backbone. This payment mechanism promotes care fragmentation and discourages team-based, person- and family-centered care, provided conveniently and more affordably at home for those with serious illness. In addition, our health care system continues to emphasize treatment for acute illness rather than quality of life.
The great news is that today we are at an inflection point where a more rational and successful system of care is possible. And some pioneering, independent initiatives are leading the way to bring a sense of order and reason to the care experienced by those with advanced illness. It is called community-based palliative care.
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