Most Americans do not have an advance directive. And most of those advance directives are not available when the patient is admitted and incapacitated. Sadly only a small subset of patients satisfy both these conditions: (1) advance directive completed and (2) advance directive available. But those patients benefit in terms of achieving value congruent care.
A new study in JAGS shows that patients aged ≥ 65 years with EHR-documented advance directives ≥ 6 months before death were less likely to receive potentially burdensome end-of-life (EOL) care within the last 6 months of life (19.9% vs. 26.8%) and less likely to die in the hospital (23.2% vs. 32.1%) compared with those without an EHR-documented AD.
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