Medical Care in the Last Twelve Months of Life: The Relation between Age, Functional Status, and Medical Care Expenditures

Medical care expenditures of a group of decedents during their last year of life suggest that high-technology medical services may be allocated more rationally than is generally assumed. Patients who received intensive hospital and physician services were largely the "young old," aged 65 t...

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Bibliographic Details
Published in:The Milbank quarterly 1988, Vol.66 (4), p.640-660
Main Author: Scitovsky, Anne A.
Format: Article
Language:English
Subjects:
Activities of Daily Living
Adult
Age Factors
Age groups
Aged
Aged, 80 and over
Bioethics
California
Cause of Death
Costs
Elderly
Female
Health
Health Care
Health Expenditures - statistics & numerical data
Health Services - utilization
Health Status
Home Care Services
Hospital admissions
Hospital costs
Hospitalization
Humans
Male
Medicare
Middle Aged
Nursing homes
Older adults
Patient care
Patient Selection
Physicians
Rationing
Resource Allocation
Retrospective Studies
Technology, High-Cost - supply & distribution
Withholding Treatment
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Summary:Medical care expenditures of a group of decedents during their last year of life suggest that high-technology medical services may be allocated more rationally than is generally assumed. Patients who received intensive hospital and physician services were largely the "young old," aged 65 to 79 years with good functional status, while the frail "older old," aged 80 years and over, received largely supportive care. Total care expenses of the older old were only slightly below those of the most expensive decedents, however, as expenses for nursing home and home health care more than offset lower medical service expenses. Further studies are needed before concluding that the major cause of high costs at the end of life is the inappropriate use of high-technology care.
ISSN:0887-378X
DOI:10.2307/3349934