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Research Letter
January 19, 2016

End-of-Life Care Intensity for Physicians, Lawyers, and the General Population

Author Affiliations
  • 1Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
  • 2Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota
  • 3Center for Research on End of Life Care, Weill Cornell Medicine, New York, New York
JAMA. 2016;315(3):303-305. doi:10.1001/jama.2015.17408

Care at the end of life must balance intensity of treatment with quality of life. Previous research has not determined whether physicians, the group most familiar with end-of-life care, receive higher or lower intensity end-of-life treatments compared with nonphysicians.1

Non–health maintenance organization Medicare beneficiaries aged 66 years or older who died between 2004 and 2011 in Massachusetts, Michigan, Utah, and Vermont were included due to availability of electronic death records and ability to link to Medicare. The Partners human research committee determined the study was not human research.

Death records were not available for Massachusetts in 2011 and Utah for 2004 through 2005, and approximately 10% of decedents could not be linked to Medicare claims. Death certificates documented age, education, Social Security number, and usual industry and occupation (the type of job engaged in for most of his/her working life). Industry and occupation are typically provided by family members to the funeral director and are highly accurate.2