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End-Of-Life Medical Spending In Last Twelve Months Of Life Is Lower Than Previously Reported

Author

Listed:
  • Eric French
  • Jeremy Mccauley
  • Maria Aragon
  • Pieter Bakx
  • Martin Chalkley

    (Economic Studies - University of Dundee)

  • Stacey H. Chen
  • Bent J. Christensen
  • Hongwei Chuang
  • Aurelie Côté-Sergent
  • Mariacristina de Nardi
  • Elliott Fan
  • Damien Échevin
  • Pierre-Yves Geoffard

    (PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris Sciences et Lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris Sciences et Lettres - INRA - Institut National de la Recherche Agronomique - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique)

  • Christelle Gastaldi-Ménager
  • Mette Gørtz
  • Yoko Ibuka
  • John B. Jones
  • Malene Kallestrup-Lamb
  • Martin Karlsson

    (Örebro School of Public Affairs - Örebro University)

  • Tobias J. Klein
  • Grégoire de Lagasnerie
  • Pierre-Carl Michaud

    (RAND - RAND)

  • Owen O’donnell
  • Nigel Rice
  • Jonathan S. Skinner
  • Eddy van Doorslaer
  • Nicolas R. Ziebarth

    (Cornell University [New York])

  • Elaine Kelly

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.

Suggested Citation

  • Eric 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 & Dam, 2017. "End-Of-Life Medical Spending In Last Twelve Months Of Life Is Lower Than Previously Reported," Post-Print halshs-01631529, HAL.
  • Handle: RePEc:hal:journl:halshs-01631529
    DOI: 10.1377/hlthaff.2017.0174
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    Cited by:

    1. Joan Costa‐Font & Cristina Vilaplana‐Prieto, 2020. "‘More than one red herring'? Heterogeneous effects of ageing on health care utilisation," Health Economics, John Wiley & Sons, Ltd., vol. 29(S1), pages 8-29, October.
    2. Rosalind Bell-Aldeghi & Nicolas Sirven & Morgane Guern & Christine Sevilla-Dedieu, 2022. "One last effort. Are high out-of-pocket payments at the end of life a fatality?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(5), pages 879-891, July.
    3. Shinya Sugawara & Tsunehiro Ishihara & Susumu Kunisawa & Etsu Goto & Yuichi Imanaka, 2024. "A panel vector autoregression analysis for the dynamics of medical and long‐term care expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 33(4), pages 748-763, April.
    4. Anne Vinkel Hansen & Laust Hvas Mortensen & Stella Trompet & Rudi Westendorp, 2020. "Health care expenditure in the last five years of life is driven by morbidity, not age: A national study of spending trajectories in Danish decedents over age 65," PLOS ONE, Public Library of Science, vol. 15(12), pages 1-11, December.
    5. Kasteridis, Panagiotis & Rice, Nigel & Santos, Rita, 2022. "Heterogeneity in end of life health care expenditure trajectory profiles," Journal of Economic Behavior & Organization, Elsevier, vol. 204(C), pages 221-251.
    6. Hintermann, Beat & Minke, Matthias, 2018. "The value of extending life at its end: Health care allocation in the presence of learning spillovers," Working papers 2018/15, Faculty of Business and Economics - University of Basel.
    7. Hudomiet, Péter & Hurd, Michael D. & Rohwedder, Susann, 2019. "The relationship between lifetime out-of-pocket medical expenditures, dementia, and socioeconomic status in the U.S," The Journal of the Economics of Ageing, Elsevier, vol. 14(C).
    8. Friedrich Breyer & Normann Lorenz & Gerald J. Pruckner & Thomas Schober, 2022. "Looking into the black box of “Medical Innovation”: rising health expenditures by illness type," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(9), pages 1601-1612, December.
    9. Howdon, Daniel & Rice, Nigel, 2018. "Health care expenditures, age, proximity to death and morbidity: Implications for an ageing population," Journal of Health Economics, Elsevier, vol. 57(C), pages 60-74.
    10. Audrey Tanguy-Melac & Dorian Verboux & Laurence Pestel & Anne Fagot-Campagna & Philippe Tuppin & Christelle Gastaldi-Ménager, 2021. "Evolution of health care utilization and expenditure during the year before death in 2015 among people with cancer: French snds-based cohort study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(7), pages 1039-1052, September.
    11. John M. Friend & Dana L. Alden, 2021. "Improving Patient Preparedness and Confidence in Discussing Advance Directives for End-of-Life Care with Health Care Providers in the United States and Japan," Medical Decision Making, , vol. 41(1), pages 60-73, January.
    12. Friedrich Breyer & Normann Lorenz & Gerald Pruckner & Thomas Schober, 2021. "Looking into the Black Box of “Medical Progress”: Rising Health Expenditures by Illness Type and Age," Economics working papers 2021-03, Department of Economics, Johannes Kepler University Linz, Austria.
    13. Vernon, Erin & Hughes, M. Courtney & Kowalczyk, Monica, 2022. "Measuring effectiveness in community-based palliative care programs: A systematic review," Social Science & Medicine, Elsevier, vol. 296(C).
    14. Ya‐Chuan Hsu & Feng‐Yuan Chu & Tzeng‐Ji Chen & Li‐Fang Chou & Hsiao‐Ting Chang & Ming‐Hwai Lin & Shinn‐Jang Hwang, 2019. "Lots of little ones: Analysis of charitable donations to a hospice and palliative care unit in Taiwan," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1810-1819, October.
    15. Bom, Judith & Bakx, Pieter & van Doorslaer, Eddy & Gørtz, Mette & Skinner, Jonathan, 2023. "What explains different rates of nursing home admissions? Comparing the United States to Denmark and the Netherlands," The Journal of the Economics of Ageing, Elsevier, vol. 25(C).

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