Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life

Health care delivery for people nearing the end of life has changed significantly in the past two decades. Factors such as the increasing number of elderly Americans, structural barriers in access to care for certain populations, and a fragmented health care system present challenges to providing quality care near the end of life. There are, however, opportunities to improve this care, including a better understanding of ways to improve individuals' participation in advance care planning and shared decision making, provisions of the Patient Protection and Affordable Care Act (ACA), and efforts to develop quality measures to enable accountability. In light of these developments, the Institute of Medicine was asked to produce a comprehensive report on the current state of care for people of all ages who may be approaching death. The report focuses specifically on the subset of people with "a serious illness or medical condition who may be approaching death."