New Dartmouth Study Shows Need for Better Management of Chronic Illness

Palliative Care is a Solution to Problems Outlined in Study

The latest edition of the Dartmouth Atlas Project, which works to accurately describe how medical resources are distributed and used in the United States, was released this week and showed that care of chronically ill patients varies widely among academic medical centers.

The study looked at 4.7 million Medicare enrollees who died between 2000 and 2003 at 4,300 hospitals across the country, and reported that:

  • Wide variation was seen in the intensity of care delivered to chronically ill patients in the six months preceding death; some sites were five times more likely than others to utilize expensive resources such as acute care hospitalization and ICU admission.
  • The highest number of days spent in the hospital by chronically ill patients in the final six months of life was at New York University Medical Center (32.1 days). The University of California, San Francisco, one of CAPC's six Palliative Care Leadership Centers, was shown at 13.3 days. The national length of stay average was 13.9.
  • University of California, San Francisco, one of CAPC's six Palliative Care Leadership Centers, had an average ICU stay during the same period of only 3.2 days.
  • Doctors who kept patients for longer periods of time relied too heavily on the more expensive hospital settings and could have saved Medicare $40 billion if they had been more efficient.

The value of this study for the palliative care field is significant because palliative care can be offered as a solution to the problems outlined in the study. Palliative care's ability to expertly communicate with patients and families, as well as control their pain, symptoms and other suffering, protects patients from overtreatment and inappropriate treatment. This improves quality of care for patients, thereby reducing length of stay and costs for hospitals.

To access the full study, press release, and interactive data tools from the Dartmouth Atlas of Health Care, please visit

The Center to Advance Palliative Care, located at the Mount Sinai School of Medicine (NY), is a national initiative of The Robert Wood Johnson Foundation, providing hospitals and other healthcare settings with tools and technical assistance to develop hospital-based palliative care programs.

CONTACT: Lisa Morgan, LDM Strategies, 212-924-6182 or