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

Eric B. French; Jeremy McCauley; Maria Aragon; Pieter Bakx; Martin Chalkley; Stacey H. Chen; Bent J. Christensen; Hongwei Chuang; Aurelie Côté-Sergent; Mariacristina De Nardi; Elliott Fan; Damien échevin; Pierre Yves Geoffard; Christelle Gastaldi-Ménager; Mette Gørtz; Yoko Ibuka; John B. Jones; Malene Kallestrup-Lamb; Martin Karlsson; Tobias J. Klein; Grégoire de Lagasnerie; Pierre Carl Michaud; Owen O'Donnell; Nigel Rice; Jonathan S. Skinner; Eddy van Doorslaer; Nicolas R. Ziebarth; Elaine Kelly

doi:10.1377/hlthaff.2017.0174

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

Eric B. French, Jeremy McCauley, Maria Aragon, Pieter Bakx, Martin Chalkley, Stacey H. Chen, Bent J. Christensen, Hongwei Chuang, Aurelie Côté-Sergent, Mariacristina De Nardi, Elliott Fan, Damien échevin, Pierre Yves Geoffard, Christelle Gastaldi-Ménager, Mette Gørtz, Yoko Ibuka, John B. Jones, Malene Kallestrup-Lamb, Martin Karlsson, Tobias J. KleinGrégoire de Lagasnerie, Pierre Carl Michaud, Owen O'Donnell, Nigel Rice, Jonathan S. Skinner, Eddy van Doorslaer, Nicolas R. Ziebarth, Elaine Kelly

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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.

Original language	English (US)
Pages (from-to)	1211-1217
Number of pages	7
Journal	Health Affairs
Volume	36
Issue number	7
DOIs	https://doi.org/10.1377/hlthaff.2017.0174
State	Published - Jul 1 2017
Externally published	Yes

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Publisher Copyright:
© 2017 Project HOPE-The People-to-People Health Foundation, Inc.

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French, E. B., McCauley, J., Aragon, M., Bakx, P., Chalkley, M., Chen, S. H., Christensen, B. J., Chuang, H., Côté-Sergent, A., Nardi, M. D., Fan, E., échevin, D., Geoffard, P. Y., Gastaldi-Ménager, C., Gørtz, M., Ibuka, Y., Jones, J. B., Kallestrup-Lamb, M., Karlsson, M., ... Kelly, E. (2017). End-of-life medical spending in last twelve months of life is lower than previously reported. Health Affairs, 36(7), 1211-1217. https://doi.org/10.1377/hlthaff.2017.0174

French, EB, McCauley, J, Aragon, M, Bakx, P, Chalkley, M, Chen, SH, Christensen, BJ, Chuang, H, Côté-Sergent, A, Nardi, MD, Fan, E, échevin, D, Geoffard, PY, Gastaldi-Ménager, C, Gørtz, M, Ibuka, Y, Jones, JB, Kallestrup-Lamb, M, Karlsson, M, Klein, TJ, Lagasnerie, GD, Michaud, PC, O'Donnell, O, Rice, N, Skinner, JS, Doorslaer, EV, Ziebarth, NR & Kelly, E 2017, 'End-of-life medical spending in last twelve months of life is lower than previously reported', Health Affairs, vol. 36, no. 7, pp. 1211-1217. https://doi.org/10.1377/hlthaff.2017.0174

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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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AU - Michaud, Pierre Carl

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AU - Rice, Nigel

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

Abstract

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