GAO Reports on Advance Directive Oversight, Prevalence, and Challenges

​In 2013, 47% of adults age 40 or older had an advance directive, but estimated prevalence varies by provider type and an individual's demographic characteristics, states an April 29, 2015, report from the U.S. Government Accountability Office (GAO). According to the report, which examines how the Centers for Medicare and Medicaid Services oversees providers' implementation of the advance directive requirement in the Patient Self-Determination Act, 88% of discharged hospice patients had advance directives in 2007, compared with 65% of nursing home patients in 2004. A research review revealed that individuals who were older, were white, had higher education or incomes, or were women were more likely to have advance directives than others.