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Arch Intern Med. 2000;160:743-747.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

RECENT DATA^1-4 suggested that the current health care system is providing inadequate care for dying patients, and numerous organizations^5-8 have called for improvements in end-of-life care. It was proposed that external quality measures could be used to improve care at the end of life^9-11 by holding health care organizations accountable for quality medical care for dying patients and by allowing consumers to use the results of these measures to choose among different health care plans. Others^{6, 9, 12} focused efforts on identifying domains relevant to this patient population (see Table 1 for examples) and on developing and identifying instruments to assess specific outcomes within these domains for quality improvement efforts.^{6, 10, 13-15} In this article, we argue that end-of-life care is fundamentally different from other medical care that is measurable by existing quality indicators. To expect measurable improvements across multiple domains in a process as complex and variable as end-of-life care either by external . . . [Full Text of this Article]

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