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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.

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File URL: http://www.sciencedirect.com/science/article/pii/S0168-8510(08)00218-2
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Article provided by Elsevier in its journal Health Policy.

Volume (Year): 90 (2009)
Issue (Month): 2-3 (May)
Pages: 270-276

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Handle: RePEc:eee:hepoli:v:90:y:2009:i:2-3:p:270-276
Contact details of provider: Web page: http://www.elsevier.com/locate/healthpol

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  1. Friedrich Breyer & Stefan Felder, 2004. "Life Expectancy and Health Care Expenditures: A New Calculation for Germany Using the Costs of Dying," Discussion Papers of DIW Berlin 452, DIW Berlin, German Institute for Economic Research.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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..
  7. 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.
  8. Tim Miller, 2001. "Increasing longevity and medicare expenditures," Demography, Springer;Population Association of America (PAA), vol. 38(2), pages 215-226, May.
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