2004-08-24 at 9:17 a.m.
Don't Die In Alaska...
In America, the way we die is largely determined by where we live. Geography dictates what kind of care is provided to the dying and whether death following a long illness occurs at home, in a hospital or in a nursing home. But don't move just yet. Patients can gain control over how they die by talking about end-of-life care with their families and physicians. If patients speak up, sheer numbers will force the health care system to take better care of the dying. Over the next 30 years, the number of people older than 85 will more than double to 9 million.
To create our state-by-state listing of the Best Places to Die, we looked at the following criteria:
Health care quality: Rankings of health care quality come from a recent report from the Office of Clinical Standards and Quality at the Centers for Medicare & Medicaid Services. Stephen F. Jencks and his colleagues looked at how health care had changed between 1998 and 2001 by examining, state by state, how well patients were treated for a variety of diseases, from heart disease to pneumonia. We used the latest available data, originally published in the Journal of the American Medical Association. These rankings comprised approximately 44% of our total ranking.
Legal protection: We looked at the legislative framework of each state in terms of the quality of their elder law. In order to be able to rank the states, we used ratings based on an analysis by Charles Sabatino, JD, assistant director of the American Bar Association Commission on Law and Aging, that appeared in the 2002 report "Means to a Better End: A Report On Dying in America Today," published by Last Acts, a national coalition to improve care and caring at the end of life.
The report gave scores between 1 and 5 for all 50 states depending on how comprehensive and unified their legal framework was. To facilitate an immediate grasp of the data, we translated these scores into letter grades. These scores comprised about 9% of our final score.
1 Utah: 5 B-
2 Oregon: 11 B+
3 Delaware: 14 A+
4 Colorado: 7 B+
5 Hawaii: 16 A
6 New Hampshire: 1 C
7 Iowa: 6 B-
8 North Dakota: 4 B
9 Vermont: 2 D
10 Montana: 13 B
11 Connecticut: 9
12 Maine: 3 A+
13 Virginia: 18 A-
14 Idaho: 22 B
15 Michigan: 26 A
16 Wisconsin: 8 C
17 New Mexico: 36 A+
18 Washington: 19 B
19 Massachusetts: 15 B+
20 Minnesota: 10 B+
21 Florida: 41 A+
22 Maryland: 25 A
23 West Virginia: 34 A-
24 South Carolina: 32 C+
25 North Carolina: 23 C+
26 Wyoming: 21 B
27 Arizona: 29 B+
28 Nevada: 35 C+
29 Alabama: 42 B+
30 New York: 24 B+
31 Missouri: 28 B-
32 California: 44 B
33 Nebraska: 12 C
34 Alaska: 33 C-
35 Tennessee: 39 C+
36 Georgia: 47 B+
37 Indiana: 27 C+
38 Kentucky: 40 B
39 South Dakota: 20 B-
40 Rhode Island: 17 B-
41 Kansas: 30 C-
42 Oklahoma: 45 C+
43 Arkansas: 48 B
44 Pennsylvania: 31 C-
45 Texas: 49 B-
46 New Jersey: 43 B
47 Mississippi: 50 B+
48 Louisiana: 51 B
49 Ohio: 38 C+
50 Illinois: 46 A-
51 Washington, D.C.: 37 B
Brought to you by Forbes Money on MSN.com
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