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Terminally Ill Patients And Their Physicians Delay Conversations About End-of-Life Choices, Study Finds
About half of terminally ill patients do not have discussions with their physicians regarding end-of-life choices, according to a Harvard Medical School study published in the Archives of Internal Medicine, the Boston Globe reports.The study, funded by the National Cancer Institute, examined files on 1,517 patients in California, Iowa and Alabama with metastasized lung cancer. According to the Globe, a majority of patients diagnosed with metastasized lung cancer do not survive two years. Researchers asked the patients whether a physician or other health care provider had recommended hospice care or discussed end-of-life care preferences with them. According to the study, about 49% of blacks and 43% of Hispanics had discussed end-of-life care preferences with a physician or health care provider within four to seven months of their diagnosis, compared with 53% of whites and 57% of Asians. Lead study author Haiden Huskamp, an associate professor at Harvard Medical School, said, "Patients who had unrealistic expectations about how long they had to live were much less likely to talk about hospice with their doctor." Huskamp theorized that patients who said they did not discuss end-of-life options with providers might not have completely understood their prognosis or chose to believe in a better outcome. Huskamp also said physicians typically are not well-trained to handle some delicate conversations (Lazar, Boston Globe, 5/26).
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Patients Say Costs Determining Factor In Their Treatment Decisions
Seventy-three percent of insured patients receiving assistance from Patient Access Network (PAN) Foundation reported that health care costs are influencing their medication and treatment decisions more this year than last. Nearly half of these said that cost is having a "very big" or "big" impact on whether they seek treatment or fill prescriptions.
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JHPIEGO's Dr. Harshad Sanghvi Receives International Health Award - Global Health Council Present Award For Best Practices In Global Health On May 28
Jhpiego, an international non-profit health organization affiliated with Johns Hopkins University, is pleased to announce that Dr. Harshad Sanghvi, Vice President and Medical Director of Jhpiego, has been awarded the 2009 Award for Best Practices in Global Health from the Global Health Council.
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Work Status Changes More Common Among Women Receiving Chemotherapy For Breast Cancer, Study Says

Women with breast cancer who receive chemotherapy appear more likely than those treated with radiation therapy to experience a major change in work status, according to a study published in the journal Cancer, Reuters reports. For the study, Dana-Farber Cancer Institute researcher Michael Hassett and colleagues used a large health insurance claims database to identify 3,233 women who were first diagnosed with breast cancer between 1998 and 2002. All of the women were younger than age 64, insured, and working full time or part time as of diagnosis. About 54% of the women received chemotherapy, and 58% received radiation therapy.Hassett said that most of the women did "not experience a significant change in their employment after cancer diagnosis and treatment." However, of the 6.6% who experienced such a change, those who received chemotherapy had a 1.8-fold greater risk of leaving work, retiring or going on long-term disability leave in the subsequent year. Sixty-seven percent of women who experienced a change went from full-time employment to early retirement, while the rest went from full-time employment to long-term disability or retirement, or their status was unknown. Although the study looked at many factors, only chemotherapy and older age were associated with an increased likelihood of a change in employment. Hassett said that most of the participants in the study worked for large employers that offered health insurance. He added that further research is needed to evaluate the effect of cancer diagnosis and treatment on work status for women who are self-employed or work for smaller companies (Hendry, Reuters, 6/30). Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women"s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women"s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company. © 2009 The Advisory Board Company. All rights reserved.


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