Hospitals are for End-of Life Care?

I am taking one of those free online open-university classes right now. (There are hundreds of topics from great universities-Google it, you will probably find something you like). In any event, this particular one is from Glasgow University in Scotland and is about end-of-life issues. One of the lessons asked students to define the Purpose of hospitals. I (and all of the other students in the discussion forum) came up with the usual list...emergency care, surgeries, diagnosis of illnesses, life saving procedures, etc. None of us listed end-of-life care as a Purpose of hospitals--yet about 60% of Americans die in hospitals. Think about it--hospitals are where most people die, but it is not recognized as being one of their purposes--not even by hospital administrators and staff. Is it any wonder that that they do a lousy job of end-of-life-care? That's what I would call a systems problem.

Another interesting thing I found in the lesson was that there is a wide variation among countries in where people die. The U.S. at 60% is not the highest, but it is toward the high end. Some countries have specialized hospice-type units, and of course, in many "less developed" nations most people die at home, cared for by family.