La falta de directivas anticipadas y su costo en salud – BMJ

Kate A Levin: Low uptake of advance directives and the cost to public health

The older population in every country in the world is growing.1In several high income countries, the increased health burden of older people on public spending is occurring at a time of austerity, reducing the means with which to address this issue year on year. As a consequence, there is a growing focus on anticipatory and advance care planning and the development of new models of health care delivery to optimise scarce resources in maintaining people’s wellbeing and ability to live at home for as long as possible.2,3 As well as improving people’s quality of life, economic savings are made by minimising unnecessary time spent in hospital. This can be achieved by reducing avoidable admissions to hospital, creating efficient systems within hospital, and developing a discharge pathway for those deemed medically “ready for discharge.” One reason for remaining in hospital beyond this point is a lack of advance directive, which gives durable power of attorney to a surrogate decision maker.

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