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

Research output: Contribution to journalArticle

26 Citations (Scopus)

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 languageEnglish
Pages (from-to)1211-1217
Number of pages7
JournalHealth Affairs
Volume36
Issue number7
DOIs
Publication statusPublished - 2017 Jul 1

ASJC Scopus subject areas

  • Health Policy

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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