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

Eric French; Jeremy  McCauley; Maria Aragon; Pieter Bakx; Martin Chalkley; Stacey Chen; Bent Jesper Christensen; Hongwei Chuang; Aurelie Cote-Sergent; Mariacristina De Nardi; Elliott Fan; Damien Echevin; Pierre-Yves Geoffard; Christelle Gastaldi-Menager; Mette Gørtz; Yoko Ibuka; John B. Jones; Malene Kallestrup-Lamb; Martin Karlsson; Tobias J. Klein; Gregoire de Lagasnerie; Pierre-Carl Michaud; Owen O'Donnell; Nigel Rice; Jonathan S.  Skinner; Eddy van Doorslaer; Nicholas Ziebarth; Elaine Kelly

doi:10.1377/hlthaff.2017.0174

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

Eric French, Jeremy McCauley , Maria Aragon, Pieter Bakx, Martin Chalkley, Stacey Chen, Bent Jesper Christensen, Hongwei Chuang, Aurelie Cote-Sergent, Mariacristina De Nardi, Elliott Fan, Damien Echevin, Pierre-Yves Geoffard, Christelle Gastaldi-Menager, Mette Gørtz, Yoko Ibuka, John B. Jones, Malene Kallestrup-Lamb, Martin Karlsson, Tobias J. KleinGregoire de Lagasnerie, Pierre-Carl Michaud, Owen O'Donnell, Nigel Rice, Jonathan S. Skinner, Eddy van Doorslaer, Nicholas Ziebarth, Elaine Kelly

Department of Economics

45 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 language	English
Journal	Health Affairs
Volume	36
Issue number	7
Pages (from-to)	1211-1217
ISSN	0278-2715
DOIs	https://doi.org/10.1377/hlthaff.2017.0174
Publication status	Published - 1 Jul 2017

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1377/hlthaff.2017.0174

hlthaff.2017.0174Final published version, 299 KB

Cite this

French, E., McCauley , J., Aragon, M., Bakx, P., Chalkley, M., Chen, S., Christensen, B. J., Chuang, H., Cote-Sergent, A., De Nardi, M., Fan, E., Echevin, D., Geoffard, P.-Y., Gastaldi-Menager, 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

French, E, McCauley , J, Aragon, M, Bakx, P, Chalkley, M, Chen, S, Christensen, BJ, Chuang, H, Cote-Sergent, A, De Nardi, M, Fan, E, Echevin, D, Geoffard, P-Y, Gastaldi-Menager, C, Gørtz, M, Ibuka, Y, Jones, JB, Kallestrup-Lamb, M, Karlsson, M, Klein, TJ, de Lagasnerie, G, Michaud, P-C, O'Donnell, O, Rice, N, Skinner, JS, van Doorslaer, E, Ziebarth, N & Kelly, E 2017, 'End-Of-Life Medical Spending In Last Twelve Months Of Life Is Lower Than Previously Reported', Health Affairs, vol. 36, no. 7, pp. 1211-1217. https://doi.org/10.1377/hlthaff.2017.0174

@article{b649ff430a3e41e6a56eb131f7da9c4f,

title = "End-Of-Life Medical Spending In Last Twelve Months Of Life Is Lower Than Previously Reported",

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.",

author = "Eric French and Jeremy McCauley and Maria Aragon and Pieter Bakx and Martin Chalkley and Stacey Chen and Christensen, {Bent Jesper} and Hongwei Chuang and Aurelie Cote-Sergent and {De Nardi}, Mariacristina and Elliott Fan and Damien Echevin and Pierre-Yves Geoffard and Christelle Gastaldi-Menager and Mette G{\o}rtz and Yoko Ibuka and Jones, {John B.} and Malene Kallestrup-Lamb and Martin Karlsson and Klein, {Tobias J.} and {de Lagasnerie}, Gregoire and Pierre-Carl Michaud and Owen O'Donnell and Nigel Rice and Skinner, {Jonathan S.} and {van Doorslaer}, Eddy and Nicholas Ziebarth and Elaine Kelly",

year = "2017",

month = jul,

day = "1",

doi = "10.1377/hlthaff.2017.0174",

language = "English",

volume = "36",

pages = "1211--1217",

journal = "Health Affairs",

issn = "0278-2715",

publisher = "Project HOPE",

number = "7",

}

TY - JOUR

T1 - End-Of-Life Medical Spending In Last Twelve Months Of Life Is Lower Than Previously Reported

AU - French, Eric

AU - McCauley , Jeremy

AU - Aragon, Maria

AU - Bakx, Pieter

AU - Chalkley, Martin

AU - Chen, Stacey

AU - Christensen, Bent Jesper

AU - Chuang, Hongwei

AU - Cote-Sergent, Aurelie

AU - De Nardi, Mariacristina

AU - Fan, Elliott

AU - Echevin, Damien

AU - Geoffard, Pierre-Yves

AU - Gastaldi-Menager, Christelle

AU - Gørtz, Mette

AU - Ibuka, Yoko

AU - Jones, John B.

AU - Kallestrup-Lamb, Malene

AU - Karlsson, Martin

AU - Klein, Tobias J.

AU - de Lagasnerie, Gregoire

AU - Michaud, Pierre-Carl

AU - O'Donnell, Owen

AU - Rice, Nigel

AU - Skinner, Jonathan S.

AU - van Doorslaer, Eddy

AU - Ziebarth, Nicholas

AU - Kelly, Elaine

PY - 2017/7/1

Y1 - 2017/7/1

N2 - 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.

AB - 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.

U2 - 10.1377/hlthaff.2017.0174

DO - 10.1377/hlthaff.2017.0174

M3 - Journal article

C2 - 28679807

SN - 0278-2715

VL - 36

SP - 1211

EP - 1217

JO - Health Affairs

JF - Health Affairs

IS - 7

ER -

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

Abstract

UN SDGs

Access to Document

Fingerprint

Cite this