Featured Research

from universities, journals, and other organizations

Patients with advanced dementia more likely to receive feeding tube at larger, for-profit hospitals

Date:
February 9, 2010
Source:
JAMA and Archives Journals
Summary:
Despite being of questionable benefit for patients with advanced dementia, new research finds that hospitals with certain characteristics, such as those that are larger or for-profit, are more likely to have a higher rate of feeding tube placement, according to a new study

Despite being of questionable benefit for patients with advanced dementia, new research finds that hospitals with certain characteristics, such as those that are larger or for-profit, are more likely to have a higher rate of feeding tube placement, according to a study in the February 10 issue of JAMA.

Related Articles


Dementia is a leading cause of death in the United States, and estimates project that 16 million individuals will have dementia by 2050. Characteristics of advanced dementia can include severe functional impairment, eating problems, malnutrition and recurrent infections. "The decision to place a feeding tube in a patient with advanced dementia is one of the sentinel decisions that family members and health care professionals grapple with in the nursing home environment. Two widely cited structured literature reviews conclude that the use of feeding tubes in patients with advanced dementia does not improve survival, prevent aspiration pneumonia, heal or prevent decubitus ulcers [bed sores], or improve other clinical outcomes," the authors write.

Despite this evidence, a previous study reported that more than one-third of nursing home residents with advanced dementia have a feeding tube inserted, and other research has indicated that many of these patients had their feeding tube inserted during an acute care hospitalization, according to background information in the article.

Joan M. Teno, M.D., M.S., of Brown University, Providence, R.I., and colleagues examined the characteristics of acute care hospitals associated with greater rates of feeding tube insertion among nursing home residents ages 66 years or older admitted with advanced cognitive impairment. Rate of feeding tube placement was based on a 20 percent sample of all Medicare Claims files and was assessed in hospitals with at least 30 such admissions between 2000 and 2007, which was 2,797 acute care hospitals for this study.

During the study period, 280,869 admissions occurred among 163,022 nursing home residents (average age, 84.0 years; 67 percent women, and 12.5 percent black residents). Between 2000 and 2007, the hospital rate of feeding tube insertion per 100 eligible admissions decreased, from a high of 7.9 in 2000 to a low of 6.2 in 2007. The rate of feeding tube insertion varied from 0 to 38.9 per 100 hospitalizations.

A higher rate of feeding tube insertions was independently associated with for-profit ownership vs. hospitals owned by state or local government, with an absolute difference of 3.0 feeding tube insertions per 100 admissions. Hospitals with a greater number of beds (more than 310 beds vs. less than 101 beds) also had higher rates of feeding tube insertion, as did those with more intensive care unit use for chronically ill patients in the last 6 months of life.

"Feeding tube insertion in persons with advanced cognitive impairment demonstrates a disconnect with the existing evidence of their effectiveness," the authors write.

"These results are the first to our knowledge to document the national variation in rates of feeding tube insertions among acute care hospitals. Future research is needed to better understand why this variation occurs and to intervene to ensure that feeding tube insertion reflects informed patient preferences based on discussion of the evidence of risks vs. benefits."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Joan M. Teno; Susan L. Mitchell; Pedro L. Gozalo; David Dosa; Amy Hsu; Orna Intrator; Vincent Mor. Hospital Characteristics Associated With Feeding Tube Placement in Nursing Home Residents With Advanced Cognitive Impairment. JAMA, 2010; 303 (6): 544-550 [link]

Cite This Page:

JAMA and Archives Journals. "Patients with advanced dementia more likely to receive feeding tube at larger, for-profit hospitals." ScienceDaily. ScienceDaily, 9 February 2010. <www.sciencedaily.com/releases/2010/02/100209182352.htm>.
JAMA and Archives Journals. (2010, February 9). Patients with advanced dementia more likely to receive feeding tube at larger, for-profit hospitals. ScienceDaily. Retrieved December 21, 2014 from www.sciencedaily.com/releases/2010/02/100209182352.htm
JAMA and Archives Journals. "Patients with advanced dementia more likely to receive feeding tube at larger, for-profit hospitals." ScienceDaily. www.sciencedaily.com/releases/2010/02/100209182352.htm (accessed December 21, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Sunday, December 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Touch-Free Smart Phone Empowers Mobility-Impaired

Touch-Free Smart Phone Empowers Mobility-Impaired

Reuters - Innovations Video Online (Dec. 21, 2014) A touch-free phone developed in Israel enables the mobility-impaired to operate smart phones with just a movement of the head. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com
Earthworms Provide Cancer-Fighting Bacteria

Earthworms Provide Cancer-Fighting Bacteria

Reuters - Innovations Video Online (Dec. 21, 2014) Polish scientists isolate bacteria from earthworm intestines which they say may be used in antibiotics and cancer treatments. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com
Existing Chemical Compounds Could Revive Failing Antibiotics, Says Danish Scientist

Existing Chemical Compounds Could Revive Failing Antibiotics, Says Danish Scientist

Reuters - Innovations Video Online (Dec. 21, 2014) A team of scientists led by Danish chemist Jorn Christensen says they have isolated two chemical compounds within an existing antipsychotic medication that could be used to help a range of failing antibiotics work against killer bacterial infections, such as Tuberculosis. Jim Drury went to meet him. Video provided by Reuters
Powered by NewsLook.com
Hugging It Out Could Help You Ward Off A Cold

Hugging It Out Could Help You Ward Off A Cold

Newsy (Dec. 21, 2014) Carnegie Mellon researchers found frequent hugs can help people avoid stress-related illnesses. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins