If you’re lucky enough to be able to choose your hospital and have time to research your choices, you’d naturally take mortality rate into account. There’s a problem with that, and one change in how mortality rates are calculated could help solve it.
I think the authors may have missed a larger point. The variation in DNR patients may track facilities who serve more acutely ill populations. Without a more sophisticated look at the populations served, acuity of patients presenting for care, and level of patients kept versus being transferred out due to acute illness – incorporating DNR orders in the score weighting may not make them more accurate.
The interesting point for further research is whether or not DNR orders are a useful indicator or perhaps substitute measure for the other complex variables I noted above. Not having access to the study, I can’t tell whether the authors considered the point.
Most patients receiving end-of-life care want to avoid aggressive attempts to prolong their life, but medical culture and practices often contradict these wishes. Part of the problem is due to confusion surrounding do-not-resuscitate orders. Here’s what patients really need to know about the “no code.”
First-responders would likely ignore any DNR-themed jewelry, markings, or tattoos, and only a specific form from the health sector specifically targeted at first-responders would stop them from providing standard care. Are first responders going to rifle through your pockets looking for such a form while they’re trying to save your life? Probably and hopefully not. The hospital setting, however, is where living wills, DNR-orders, powers-of-attorney, next-of-kin, etc. can be more readily honoured and better detailed. You could probably check the policies in your own jurisdiction for clarification.