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Hospital Characteristics Influence Use of Do-not-resuscitate Orders

Factors include size, non-profit status and affiliation with a university, study says

TUESDAY, Aug. 9, 2005 (HealthDay News) -- The use of do-not-resuscitate orders in California are influenced by hospital characteristics such as size, non-profit status and affiliation with a university, a new study has found.

Researchers at the University of California, Los Angeles, analyzed data on 819,686 patient admissions at 386 California hospitals. They found that the percentage of do-not-resuscitate (DNR) orders written within the first 24 hours after admission varied from 2 percent for patients aged 50 to 59, to 17 percent for patients aged 80 or older.

DNR orders were much less likely to be written at for-profit vs. private non-profit hospitals, in the largest hospitals vs. the smallest hospitals, and in academic vs. non-academic institutions. Hospitals in rural areas had a higher rate of DNR orders than those in urban areas, the study said.

"The initiation of end-of-life discussions and the implementation of DNR orders are important toward ensuring that patients receive care appropriate to their prognosis and preferences," the study authors wrote.

"Hospital characteristics appear to be associated with the use of DNR orders, even after accounting for differences in patient characteristics. This association reflects institutional culture, technological bent, and physician practice patterns," the authors wrote.

The results appear in the Aug. 22 issue of the journal Archives of Internal Medicine.

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SOURCE: JAMA/Archives journals, news release, Aug. 9, 2005
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