Advance Directives for Seriously Ill Hospitalized Patients: Effectiveness with the Patient Self‐Determination Act and the SUPPORT Intervention

OBJECTIVE: To assess the effectiveness of written advance directives (ADs) in the care of seriously ill, hospitalized patients. In particular, to conduct an assessment after ADs were promoted by the Patient Self‐Determination Act (PSDA) and enhanced by the effort to improve decision‐making in the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT), focusing upon the impact of ADs on decision‐making about resuscitation.

[1]  W. Knaus,et al.  The Illusion of End‐of‐Life Resource Savings with Advance Directives , 1997, Journal of the American Geriatrics Society.

[2]  M. A. O'connor,et al.  Do Advance Directives Provide Instructions That Direct Care? , 1997, Journal of the American Geriatrics Society.

[3]  William A. Knaus,et al.  A controlled trial to improve care for seriously ill hospitalized patients. The study to understand prognoses and preferences for outcomes and risks of treatments (SUPPORT). The SUPPORT Principal Investigators. , 1995, JAMA.

[4]  D. Meier,et al.  The inaccessibility of advance directives on transfer from ambulatory to acute care settings. , 1995, JAMA.

[5]  L. Emanuel,et al.  Structured advance planning. Is it finally time for physician action and reimbursement? , 1995, JAMA.

[6]  J. Lynn,et al.  Advance care planning. Priorities for ethical and empirical research. , 1994, The Hastings Center report.

[7]  H. Welch,et al.  Advance directives and the cost of terminal hospitalization. , 1994, Archives of internal medicine.

[8]  C. Chambers,et al.  Relationship of advance directives to hospital charges in a Medicare population. , 1994, Archives of internal medicine.

[9]  S Tenner,et al.  The influence of the probability of survival on patients' preferences regarding cardiopulmonary resuscitation. , 1994, The New England journal of medicine.

[10]  E. Derenzo Functional Status Care Categories and National Health Policy , 1994, Journal of the American Geriatrics Society.

[11]  W. Knaus,et al.  Do Formal Advance Directives Affect Resuscitation Decisions and the Use of Resources for Seriously Ill Patients? , 1994, The Journal of Clinical Ethics.

[12]  N. Powe,et al.  The Cost of Ethics Legislation: A Look at the Patient Self-Determination Act , 1993, Kennedy Institute of Ethics journal.

[13]  R. Langer,et al.  Effects of Offering Advance Directives on Medical Treatments and Costs , 1992, Annals of Internal Medicine.

[14]  W. Knaus,et al.  The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults. , 1991, Chest.

[15]  L. I. Southerland,et al.  A prospective study of advance directives for life-sustaining care. , 1991, The New England journal of medicine.

[16]  E. Emanuel,et al.  Advance directives for medical care--a case for greater use. , 1991, The New England journal of medicine.

[17]  D. Murphy Improving Advance Directives for Healthy Older People , 1990, Journal of the American Geriatrics Society.

[18]  W. Knaus,et al.  Study population in SUPPORT: patients (as defined by disease categories and mortality projections), surrogates, and physicians. , 1990, Journal of clinical epidemiology.

[19]  R. Mccord,et al.  Physicians' attitudes on advance directives. , 1989, JAMA.

[20]  B. Jennett,et al.  Assessment of coma and impaired consciousness. A practical scale. , 1974, Lancet.

[21]  J. Civetta,et al.  Therapeutic intervention scoring system: a method for quantitative comparison of patient care. , 1974, Critical care medicine.