BMJ  2004;328 (13 March), doi:10.1136/bmj.328.7440.0

Variations in end of life care

The utilisation of end of life care varies widely among the "best" hospitals in the United States. Wennberg and colleagues (p 607) analysed how often doctors saw patients, how long patients stayed in hospital on average, how long they stayed in intensive care units, and what proportion went to hospices at the end of their lives. Their cohort consisted of patients treated in 77 hospitals included in the 2001 US News and World Report "best hospital" list. They found great variations in end of life care, attributable to a greater availability of facilities. In an accompanying commentary (p 610), Hunter raises concerns about the English NHS Plan, which plans to increase doctors and the number of beds but would not guarantee that better health would result.

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