JAMA : the journal of the American Medical Association
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Hospice care, an appropriate way of caring for many terminally ill patients, now is reimbursed by Medicare and other insurance systems. However, access to hospice care is limited by unavailability, ignorance, Medicare regulations, and internally imposed restrictions. Reasons for the barriers to hospice care and other appropriate terminal care are discussed, together with potential actions that might improve care for dying patients.
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Previous reports have disclosed a high morbidity and mortality in hospitalized asthmatics, especially those treated in the intensive care unit. Recently, it has been questioned whether the benefits of treating asthmatics in the intensive care unit outweigh the potential hazards. To address this issue, we examined the outcome of status asthmaticus in our medical intensive care unit between January 1, 1978, and December 31, 1987. ⋯ There were no deaths and few complications. This was accomplished by close monitoring and repetitive blood gas analysis. We believe that the previous high complication rates and mortality associated with the hospital care of status asthmaticus can be avoided.