TUESDAY, Dec. 10, 2013 (HealthDay News) -- Most Americans do not
deal with end-of-life issues and wishes, a new study indicates.
Researchers analyzed data from nearly 8,000 people who took part
in nationwide surveys conducted in 2009 and 2010, and found that
only about 26 percent had completed an advance directive, also
called a living will.
There were significant associations between completing an
advance directive and age, income, education and health status,
according to the study in the January issue of the
American Journal of Preventive Medicine.
Advance directives were more common among women, whites, married
people and those who had a college degree or postgraduate training.
People with advanced directives also were more likely to have a
chronic disease or a regular source of care.
"For black and Hispanic respondents, advance directives were
less frequent across all educational groups. These data indicate
racial and educational disparities in advance directive completion
and highlight the need for education about their role in
facilitating [end-of-life] decisions," Dr. Jaya Rao, who conducted
the study while an associate professor in the division of
pharmaceutical outcomes and policy at the University of North
Carolina, said in a journal news release.
Lack of awareness was the most common reason for not having an
Some previous studies have shown that health care costs are
highest during the final years of life, but the use of advance
directives reduces Medicare spending and the likelihood of
"Given the current discussions about implementing various models
of health care delivery, including the patient-centered medical
home, [end-of-life] issues need to come to the forefront of
planning efforts," Rao said. "Hopefully, these findings will
contribute to the current national conversations about
The U.S. Agency for Healthcare Research and Quality has more