Larger, for-profit hospitals may be using too many feeding tubes on patients with advanced dementia without improving the quality of their care, a study finds, according to HealthDay News/Business Week
. "Our results suggest that decisions about feeding tubes are more about which hospital you go to than a decision-making process that really elicits and supports patient choice," said the physician who led the study, which appears in today's Journal of the American Medical Association.
"For-profit hospitals, along with facilities that had 310 beds or more and those that had the most use of intensive care during the last six months of a person's life, were more likely to use feeding tubes," HealthDay reports. One reason that feeding tubes tend to be overused in general is that the Medicaid and Medicare systems include conflicting incentives. Nursing homes that receive Medicaid reimbursements have an incentive to send patients to hospitals, where Medicare will reimburse their care, the physician-researcher said (Gardner, 2/9).