Cause-Specific Mortality among Medicare Enrollees

Life tables with specific causes of death, particularly when adjusted for demographic and other personal characteristics, can be important components of cost-effectiveness and other economic studies. However, there are few sources of nationally representative information that can be used to develop life tables that incorporate cause-specific mortality. To produce such estimates, we relate annual mortality rates to a set of individual characteristics, applying a statistical model with a flexible functional form to data obtained from a random sample of Medicare eligibility and hospital insurance files, covering the years 1986-1990. Insofar as national data sources can be found to compare to the estimates of these models, the results are comparable. For example, the survival figures are comparable to the life table figures supplied as part of the series of vital statistics of the United States. The framework can be extended to analyze expenditures for both inpatient and outpatient care and to estimate lifetime profiles of Medicare expenditures for individuals falling into various demographic and clinical categories. The framework can also be extended to analyze the mortality and utilization associated with use of specific procedures.