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Temporal trends in the relative cost of dying: Evidence from Canada


  • Payne, Greg
  • Laporte, Audrey
  • Foot, David K.
  • Coyte, Peter C.


Objective To measure change over time in the relationship between health care expenditures for individuals that die in a given year and age matched survivors.Methods Administrative data covered government-funded hospital, physician, prescription drug, and continuing care services for the entire population aged 65 and over in the province of British Columbia between 1991 and 2001. Individuals were separated according to age group and decedent/survivor status. The average utilization cost was estimated for each age group and survivor status in each year from 1991 to 2001. Time trends in decedent and survivor costs, and the ratio between the two, were analyzed for each service category.Results Inflation-adjusted decedent costs rose by almost 10% between 1991 and 2001, while survivor costs fell slightly. The ratio of decedent to survivor costs increased for all age groups, and was greatest for hospital and continuing care costs. Although the study population mortality rate fell over the study period, the proportion of health care costs allocated to decedents grew by 8%.Conclusions If mortality rates continue to fall, lower survivor costs and higher decedent costs will lower future growth in health expenditures due to aging.

Suggested Citation

  • Payne, Greg & Laporte, Audrey & Foot, David K. & Coyte, Peter C., 2009. "Temporal trends in the relative cost of dying: Evidence from Canada," Health Policy, Elsevier, vol. 90(2-3), pages 270-276, May.
  • Handle: RePEc:eee:hepoli:v:90:y:2009:i:2-3:p:270-276

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    References listed on IDEAS

    1. Tim Miller, 2001. "Increasing longevity and medicare expenditures," Demography, Springer;Population Association of America (PAA), vol. 38(2), pages 215-226, May.
    2. Thai-Thanh Dang & Pablo Antolín & Howard Oxley, 2001. "Fiscal Implications of Ageing: Projections of Age-Related Spending," OECD Economics Department Working Papers 305, OECD Publishing.
    3. Alan M. Garber & Thomas E. MaCurdy & Mark C. McClellan, 1998. "Medical Care at the End of Life: Diseases, Treatment Patterns, and Costs," NBER Working Papers 6748, National Bureau of Economic Research, Inc.
    4. Seshamani, Meena & Gray, Alastair M., 2004. "A longitudinal study of the effects of age and time to death on hospital costs," Journal of Health Economics, Elsevier, vol. 23(2), pages 217-235, March.
    5. Breyer, Friedrich & Felder, Stefan, 2006. "Life expectancy and health care expenditures: A new calculation for Germany using the costs of dying," Health Policy, Elsevier, vol. 75(2), pages 178-186, January.
    6. Polder, Johan J. & Barendregt, Jan J. & van Oers, Hans, 2006. "Health care costs in the last year of life--The Dutch experience," Social Science & Medicine, Elsevier, vol. 63(7), pages 1720-1731, October.
    7. Wickstrom, Jannie & Serup-Hansen, Niels & Kristiansen, Ivar Sonbo, 2002. "Future health care costs--do health care costs during the last year of life matter?," Health Policy, Elsevier, vol. 62(2), pages 161-172, November.
    8. McGrail, K. & Green, B. & Barer, M.L. & Evans, R.G. & Hertzman, C., 2000. "Age, Costs of Acute and Long-term Care and Proximity to Death: Evidence for 1987-88 and 1994-94 in Btitish Columbia," Centre for Health Services and Policy Research 2000:8, University of British Columbia - Centre for Health Services and Policy Research..
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    Cited by:

    1. Asada, Yukiko & Kephart, George & Hurley, Jeremiah & Yoshida, Yoko & Smith, Andrea & Bornstein, Stephen, 2012. "The role of proximity to death in need-based approaches to health care," Health Policy, Elsevier, vol. 106(3), pages 291-302.
    2. Melberg, Hans Olav & Sørensen, Jan, 2013. "How does end of life costs and increases in life expectancy affect projections of future hospital spending?," HERO On line Working Paper Series 2013:9, Oslo University, Health Economics Research Programme.
    3. Lilly, Meredith B. & Laporte, Audrey & Coyte, Peter C., 2010. "Do they care too much to work? The influence of caregiving intensity on the labour force participation of unpaid caregivers in Canada," Journal of Health Economics, Elsevier, vol. 29(6), pages 895-903, December.


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