Levels of Care Vary Widely in U.S., Study Finds

The amount of medical care Americans receive in their final months of life varies enormously in different parts of the country, a new study says, suggesting that treatment depends on how much care is available to dying patients--not on how much they really need.

The study found that on much of the East Coast, people are more than twice as likely to die in the hospital as people in the West. It also found fivefold differences across regions in the percentage of patients who spend some of their last six months hooked up to tubes in an intensive care unit.

Those variations exist, say findings to be released today, even though there is no evidence that residents are any sicker or live any longer in the places where patients receive the most medical treatment.

John E. Wennberg, principal author, said the amount of care patients receive is linked closely to the supply of hospital beds and doctors where they happen to live. In essence, he said, the health care system finds ways of using what it has to offer, paying inadequate attention to what patients prefer.