Use of outpatient drugs as death approaches.
This article explores changes in outpatient prescription drug use up to 72 months prior to death and relates the findings to trends in Medicare-covered services during the same life stage. The study sample comprises 5,261 decedents who, prior to their deaths, had enrolled in the Pennsylvania Pharmaceutical Assistance Contract for the Elderly (PACE) program. Descriptive time-series show steady increases in both outpatient drug use and physician contacts in the final 36 months of life. However, multivariate analysis shows that impending death is associated with significant reductions in the probability of using outpatient drugs. Only in the final 12 months of life is this effect offset by rising numbers of drug claims by prescription users.
Department of Health Policy and Administration, The Pennsylvania State University, University Park 16801.
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B
Stuart
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NE
Coulson
D000368:Aged; D000553:Ambulatory Care / Q000191:economics*; D003625:Data Collection; D011307:Drug Prescriptions / Q000191:economics*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D006302:Health Services Research / Q000379:methods; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000706:statistics & numerical data*; D006278:Medicare / Q000706:statistics & numerical data*; D010045:Outpatients / Q000706:statistics & numerical data; D010414:Pennsylvania; D013727:Terminal Care / Q000191:economics* / Q000706:statistics & numerical data; D013997:Time Factors; D014481:United States