Systematic implementation of an advance directive program in nursing homes: a randomized controlled trial

This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Nursing home residents and the proxies for incompetent residents were willing to use advance directives when offered by trained nurses. The implementation of the advance directive programme was effective in reducing the hospital costs, as significantly more intervention patients expressed their willingness to remain in the nursing home rather than to receive care in an inpatient setting. This was achieved without affecting mortality or the residents' satisfaction.