Why is end-of-life spending so high?: evidence from cancer patients
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Working paper (Stanford Institute for Economic Policy Research)
- Author(s):
- Zeltzer, Dan, author Einav, Liran, author Finkelstein, Amy, author Shir, Tzvi, author Stemmer, Salomon M., author Balicer, Ran D., author
- Contributor(s):
- Stanford Institute for Economic Policy Research, issuing body.
- Publication:
- Stanford, CA : Stanford Institute for Economic Policy Research (SIEPR), November 2020
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Health Expenditures -- statistics & numerical data Terminal Care -- economics Neoplasms -- economics United States
- Genre(s):
- Technical Report
- Abstract:
- The concentration of healthcare spending at the end of life is widely documented but poorly understood. To gain insight, we focus on patients newly diagnosed with cancer. They display the familiar pattern: even among cancer patients with similar initial prognoses, monthly spending in the year post diagnosis is over twice as high for those who die within the year than those who survive. This elevated spending on decedents is almost entirely driven by higher inpatient spending, particularly low-intensity admissions, which rise as the prognosis deteriorates. However, even for patients with very poor prognoses at the time of admission, most low-intensity admissions do not result in death, making it difficult to target spending reductions. We also found that among patients with the same cancer type and initial prognosis, end-of-life spending is substantially more elevated for younger patients compared to older patients, suggesting that treatment decisions are not exclusively present-focused. Taken together, these results provide a richer understanding of the sources of high end-of-life spending, without revealing any natural "remedies."
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. (More information)
- Extent:
- 1 online resource (1 PDF file (67 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101776194 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101776194