End-of-life medical spending in last twelve months of life is lower than previously reported

E. French, Tobias Klein, e. a.

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Although end-of-life medical spending is often viewed as a major component of aggregate medical expenditure, accurate measures of this type of medical spending are scarce. We used detailed health care data for the period 2009–11 from Denmark, England, France, Germany, Japan, the Netherlands, Taiwan, the United States, and the Canadian province of Quebec to measure the composition and magnitude of medical spending in the three years before death. In all nine countries, medical spending at the end of life was high relative to spending at other ages. Spending during the last twelve months of life made up a modest share of aggregate spending, ranging from 8.5 percent in the United States to 11.2 percent in Taiwan, but spending in the last three calendar years of life reached 24.5 percent in Taiwan. This suggests that high aggregate medical spending is due not to last-ditch efforts to save lives but to spending on people with chronic conditions, which are associated with shorter life expectancies.
LanguageEnglish
Pages1211-1217
JournalHealth Affairs
Volume36
Issue number7
DOIs
Publication statusPublished - Jul 2017

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Life Expectancy
England
Netherlands
France
Germany
Japan
Delivery of Health Care

Keywords

  • costs and spending
  • long-term services and supports
  • end of life care
  • cost reduction
  • medicare
  • systems of care
  • cancer patients
  • quality of care
  • hospice
  • chronic disease

Cite this

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title = "End-of-life medical spending in last twelve months of life is lower than previously reported",
abstract = "Although end-of-life medical spending is often viewed as a major component of aggregate medical expenditure, accurate measures of this type of medical spending are scarce. We used detailed health care data for the period 2009–11 from Denmark, England, France, Germany, Japan, the Netherlands, Taiwan, the United States, and the Canadian province of Quebec to measure the composition and magnitude of medical spending in the three years before death. In all nine countries, medical spending at the end of life was high relative to spending at other ages. Spending during the last twelve months of life made up a modest share of aggregate spending, ranging from 8.5 percent in the United States to 11.2 percent in Taiwan, but spending in the last three calendar years of life reached 24.5 percent in Taiwan. This suggests that high aggregate medical spending is due not to last-ditch efforts to save lives but to spending on people with chronic conditions, which are associated with shorter life expectancies.",
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End-of-life medical spending in last twelve months of life is lower than previously reported. / French, E.; Klein, Tobias; a., e.

In: Health Affairs, Vol. 36, No. 7, 07.2017, p. 1211-1217.

Research output: Contribution to journalArticleScientificpeer-review

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AU - French, E.

AU - Klein, Tobias

AU - a., e.

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N2 - Although end-of-life medical spending is often viewed as a major component of aggregate medical expenditure, accurate measures of this type of medical spending are scarce. We used detailed health care data for the period 2009–11 from Denmark, England, France, Germany, Japan, the Netherlands, Taiwan, the United States, and the Canadian province of Quebec to measure the composition and magnitude of medical spending in the three years before death. In all nine countries, medical spending at the end of life was high relative to spending at other ages. Spending during the last twelve months of life made up a modest share of aggregate spending, ranging from 8.5 percent in the United States to 11.2 percent in Taiwan, but spending in the last three calendar years of life reached 24.5 percent in Taiwan. This suggests that high aggregate medical spending is due not to last-ditch efforts to save lives but to spending on people with chronic conditions, which are associated with shorter life expectancies.

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KW - costs and spending

KW - long-term services and supports

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KW - cost reduction

KW - medicare

KW - systems of care

KW - cancer patients

KW - quality of care

KW - hospice

KW - chronic disease

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