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Comment & Response
March 3, 2020

Wasteful Health Care Spending in the United States

Author Affiliations
  • 1Hope Health, Providence, Rhode Island
  • 2Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
JAMA. 2020;323(9):894-895. doi:10.1001/jama.2019.22252

To the Editor Dr Shrank and colleagues reported on “the sources of waste in health care spending” in the United States.1 Although we agree with the authors that an understanding of wasteful spending and overtreatment is important, we are concerned about their use of the term end-of-life care.

End-of-life care as a term is typically used to describe care at the end of life that focuses on quality of life and includes hospice and palliative care. According to the National Cancer Institute, the definition of end-of-life care is “care given to people who are near the end of life and have stopped treatment to cure or control their disease. End-of-life care includes physical, emotional, social, and spiritual support for patients and their families. The goal of end-of-life care is to control pain and other symptoms so the patient can be as comfortable as possible. End-of-life care may include palliative care, supportive care, and hospice care.”2

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