Four Distinct Patterns of End-Of-Life Healthcare Spending

HealthDay News — Almost half of older Medicare beneficiaries have high persistent spending throughout the full year before death, according to a study published in the June issue of Health Affairs.

Matthew Allen Davis, MPH, PhD, from the University of Michigan School of Nursing in Ann Arbor, and colleagues characterized trajectories of health care spending in the last year of life by applying a new methodology to administrative claims data for older Medicare beneficiaries who died in 2012.

The researchers identified 4 unique spending trajectories among decedents after adjustment: high persistent spending, moderate persistent spending, progressive spending, and late rise spending (48.7%, 29%, 10.2%, and 12.1%, respectively). Persistent high spending correlated with having multiple chronic conditions but not with specific diseases.

“These findings suggest that spending at the end of life is a marker of general spending patterns often set in motion long before death,” the authors write.

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Davis MA, Nallamothu BK, Banerjee M, Bynum JPW. Identification of four unique spending patterns among older adults in the last year of life challenges standard assumptions. Health Aff. 2016. doi: 10.1377/hlthaff.2015.1419.