Advance directives are more likely among seniors asked about end-of-life care preferences

被引:76
作者
Gordon, NP
Shade, SB
机构
[1] Kaiser Permanente Med Care Program, Div Res, Oakland, CA 94611 USA
[2] Univ Calif San Francisco, Gen Hosp, AIDS Program, San Francisco, CA 94143 USA
关键词
D O I
10.1001/archinte.159.7.701
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives: To estimate the proportion of seniors in a large health maintenance organization (HMO) who had been asked about their end-of-life care preferences (EOLCPs) by a clinician and who had completed an advance directive (AD). To examine the association of having had an EOLCP discussion and AD completion. Subjects and Methods: A random sample of HMO members aged 65 years or older were asked to complete a mailed survey about health and health-related issues in 1996. Data provided by 5117 seniors (80% response rate) were used to estimate the prevalence of EOLCP and AD among seniors overall and in specific risk groups. Bivariate and multiple logistic regression models were used to identify predictors of AD completion, especially having been asked about EOLCP. Results: One third of seniors reported having an AD on file with the HMO, but only 15% had talked with a clinician about EOLCP. Both having been asked about EOLCP and having an AD were positively associated with age, but not significantly associated with sex, race/ethnicity, marital status, or self-rated health status. Having been asked by a Clinician about EOLCP was significantly associated with completion of an AD. Conclusion: Clinicians can play an important role in increasing AD completion rates among seniors by bringing up the subject of EOLCPs.
引用
收藏
页码:701 / 704
页数:4
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