Comparison of Health Care Cost Trajectories in the Last Year of Life by Age at Death

Can differences in end-of-life (EOL) health care costs for Medicare beneficiaries vs younger age groups be explained solely by higher reimbursement rates in private insurance plans?In this cohort study of 313 649 decedents, EOL costs in the year before death for patients aged younger than 65 years were at least 50% higher than for those aged 65 years or older, even after standardizing to Medicare pricing and using covariate adjustment.The findings suggest a need for a better understanding of EOL patterns of care for individuals younger than 65 years and an exploration of policies to reduce their EOL costs without compromising care quality.

Corresponding Author: Ya-Chen Tina Shih, PhD, Department of Radiation Oncology, School of Medicine, University of California, Los Angeles, 650 Charles Young Dr S, Room A2-125 CHS, Los Angeles, CA 90095-6900 (yashih@mdanderson.org).

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