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

Eric B 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; Damien Échevin; Pierre-Yves Geoffard; Christelle Gastaldi-Ménager; Mette Gørtz; Yoko Ibuka; John B Jones; Malene Kallestrup-Lamb; Martin Karlsson; Tobias J Klein; Grégoire de Lagasnerie; Pierre-Carl Michaud; Owen O'Donnell; Nigel Rice; Jonathan S Skinner; Eddy van Doorslaer; Nicolas R 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 B 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, Damien Échevin, Pierre-Yves Geoffard, Christelle Gastaldi-Ménager, Mette Gørtz, Yoko Ibuka, John B Jones, Malene Kallestrup-Lamb, Martin Karlsson, Tobias J KleinGrégoire de Lagasnerie, Pierre-Carl Michaud, Owen O'Donnell, Nigel Rice, Jonathan S Skinner, Eddy van Doorslaer, Nicolas R Ziebarth, Elaine Kelly

Research output: Contribution to journal › Article › peer-review

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
Pages (from-to)	1211-1217
Number of pages	7
Journal	Health affairs (Project Hope)
Volume	36
Issue number	7
DOIs	https://doi.org/10.1377/hlthaff.2017.0174
Publication status	Published - 1 Jul 2017

Bibliographical note

© 2017, Project HOPE. This is an author-produced version of a paper accepted for publication. Uploaded with permission of the publisher/copyright holder. Further copying may not be permitted; contact the publisher for details

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© 2017, Project HOPE. This is an author-produced version of a paper accepted for publication. Uploaded with permission of the publisher/copyright holder. Further copying may not be permitted; contact the publisher for details
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http://content.healthaffairs.org/content/36/7/1211.full

Martin John Chalkley
- martin.chalkleyyork.acuk
- Centre for Health Economics - Professor
Person: Academic

Cite this

French, E. B., McCauley, J., Aragon, M., Bakx, P., Chalkley, M., Chen, S. H., Christensen, B. J., Chuang, H., Côté-Sergent, A., De Nardi, M., Fan, E., Échevin, D., Geoffard, P.-Y., Gastaldi-Ménager, 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 (Project Hope), 36(7), 1211-1217. https://doi.org/10.1377/hlthaff.2017.0174

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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 = "French, {Eric B} and Jeremy McCauley and Maria Aragon and Pieter Bakx and Martin Chalkley and Chen, {Stacey H} and Christensen, {Bent J} and Hongwei Chuang and Aurelie C{\^o}t{\'e}-Sergent and {De Nardi}, Mariacristina and Elliott Fan and Damien {\'E}chevin and Pierre-Yves Geoffard and Christelle Gastaldi-M{\'e}nager 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}, Gr{\'e}goire and Pierre-Carl Michaud and Owen O'Donnell and Nigel Rice and Skinner, {Jonathan S} and {van Doorslaer}, Eddy and Ziebarth, {Nicolas R} and Elaine Kelly",

note = "{\textcopyright} 2017, Project HOPE. This is an author-produced version of a paper accepted for publication. Uploaded with permission of the publisher/copyright holder. Further copying may not be permitted; contact the publisher for details",

year = "2017",

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doi = "10.1377/hlthaff.2017.0174",

language = "English",

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French, EB, McCauley, J, Aragon, M, Bakx, P, Chalkley, M, Chen, SH, Christensen, BJ, Chuang, H, Côté-Sergent, A, De Nardi, M, Fan, E, Échevin, D, Geoffard, P-Y, Gastaldi-Ménager, 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, NR & Kelly, E 2017, 'End-Of-Life Medical Spending In Last Twelve Months Of Life Is Lower Than Previously Reported', Health affairs (Project Hope), vol. 36, no. 7, pp. 1211-1217. https://doi.org/10.1377/hlthaff.2017.0174

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AU - French, Eric B

AU - McCauley, Jeremy

AU - Aragon, Maria

AU - Bakx, Pieter

AU - Chalkley, Martin

AU - Chen, Stacey H

AU - Christensen, Bent J

AU - Chuang, Hongwei

AU - Côté-Sergent, Aurelie

AU - De Nardi, Mariacristina

AU - Fan, Elliott

AU - Échevin, Damien

AU - Geoffard, Pierre-Yves

AU - Gastaldi-Ménager, 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, Grégoire

AU - Michaud, Pierre-Carl

AU - O'Donnell, Owen

AU - Rice, Nigel

AU - Skinner, Jonathan S

AU - van Doorslaer, Eddy

AU - Ziebarth, Nicolas R

AU - Kelly, Elaine

N1 - © 2017, Project HOPE. This is an author-produced version of a paper accepted for publication. Uploaded with permission of the publisher/copyright holder. Further copying may not be permitted; contact the publisher for details

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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 - Article

C2 - 28679807

SN - 0278-2715

VL - 36

SP - 1211

EP - 1217

JO - Health affairs (Project Hope)

JF - Health affairs (Project Hope)

IS - 7

ER -

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

Abstract

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Martin John Chalkley

Cite this