Wednesday, February 9, 2011

Aggressive Care in the Hospital- is More Better?

There is a very interesting article in the New York Times exploring the notion of 'aggressive' hospitals, with the suggestion that aggressive care, particularly following surgical complications, may lead to improved outcomes.

Photo: New York Times
The American health care system is historically well known for it's aggressive care, much of which has been criticized for it's role in spiraling costs. 

I am by no means attempting to debunk some of the studies referenced in the article, however, I must question the thought that aggressive care will guarantee a better outcome. It appears to me that aggressive, life saving interventions may serve best in the event of an acute injury or a post-operative complication. In the event of a chronic, advanced or terminal medical illness, such measures may simply delay the inevitable, cause more suffering, and yes, increase costs. 

Having recently lost a family member to a terminal, chronic disease, it was obvious to us that treatment beyond comfort measures would have been futile. 

The benefits of aggressiveness care in medicine is situational and the challenge is how to recognize and best apply it.