End-of-Life Care for Seriously Ill International Patients at a Global Destination Medical Center

Mayo Clin Proc. 2018 Dec;93(12):1720-1727. doi: 10.1016/j.mayocp.2018.08.020.

Abstract

Objective: To characterize the end-of-life care of all international patients who died at a global destination medical center from January 1, 2005, through December 31, 2015.

Patients and methods: We performed a retrospective review of all adult international patients who died at a global destination medical center from January 1, 2005, through December 31, 2015.

Results: Eighty-two international patients from 25 countries and 5 continents died during the study period (median age, 59.5 years; 59% male). Of the study cohort, 11% (n=9) completed an advance directive, 61% (n=50) died in the intensive care unit, 26% (n=21) had a full code order at the time of death, and 73% (n=19 of 26) receiving cardiopulmonary resuscitation did not survive the resuscitation process.

Conclusion: Seriously ill international patients who travel to receive health care in the United States face many barriers to receiving high-quality end-of-life care. Seriously ill international patients are coming to the United States in increasing numbers, and little is known about their end-of-life care. There are many unique needs in the care of this complex patient population, and further research is needed to understand how to provide high-quality end-of-life care to these patients.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Advance Directives / statistics & numerical data
  • Aged
  • Aged, 80 and over
  • Culturally Competent Care / standards
  • Female
  • Hospital Mortality
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Medical Tourism / statistics & numerical data*
  • Middle Aged
  • Palliative Care / standards
  • Palliative Care / statistics & numerical data
  • Retrospective Studies
  • Terminal Care / standards*
  • United States
  • Young Adult