Review shows costly futile treatment at end of life


Futile treatment at the end of patients’ lives is associated with lengthy hospital stays and costing taxpayers millions of dollars, according to new research.

A retrospective study of 907 consecutive adult admissions resulting in death at three public hospitals during six-months in 2012 found 12.1% of patients received non-beneficial treatment during their hospital stay.

The futility of treatment was determined firstly by a nurse-led medical chart audit, followed by three rounds of medical review by senior physicians across a number of specialties.

The study, led by researchers at the Queensland University of Technology, found the average length of hospital stay for patients receiving futile treatment was 15.1 days, including 9.8 days in a ward and 5.3 days in intensive care.

Extrapolated nationally, the study estimated 41,222 bed days in major tertiary hospitals were attributed to futile treatment each year.

“This translated to an annual national health system cost of $153.1 million,” the study said.

While acknowledging that even without futile treatment patients would still have required some time in hospital, the researchers said there were alternatives to acute hospital stays.

“Instead it is likely the intensity of treatment would reduce and a transfer to a sub-acute or palliative care services would have arisen.”

The study found significant differences in the rates of futile treatment between the three hospitals (range 6-19.6%), which could not be easily explained.

It said hospital-specific factors that may contribute to the provision of futile treatment, included the ‘degree of specialisation, the availability of routine tests and interventions, and organisational barriers to diverting a patient from a curative to a palliative pathway’.

They concluded interventions to reduce the frequency of futile treatment should be evaluated in an effort to ensure resources were allocated to treatments that deliver the most patient benefit.

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