title: A longitudinal study of the effects of age and time to death on hospital costs.
abstract: Recent studies indicate that approaching death, rather than age, may be the main demographic driver of health care costs. Using a 29-year longitudinal English dataset, this paper uses more robust methods to examine the effects of age and proximity to death on hospital costs. A random effects panel data two-part model shows that approaching death affects costs up to 15 years prior to death. The large tenfold increase in costs from 5 years prior to death to the last year of life overshadows the 30% increase in costs from age 65 to 85. Hence, expenditure projections must consider remaining life expectancy in the populations.
authors.affiliation: University of Pennsylvania School of Medicine, Philadelphia, PA, USA. meena.seshamani@marshallscholarship.org
authors.forename: Meena
authors.initials: M
authors.lastname: Seshamani
authors.forename: Alastair M
authors.initials: AM
authors.lastname: Gray
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003643:Death; D003644:Death Certificates; D004739:England; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data; D017721:Hospital Costs / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data / Q000639:trends*; D015993:Life Tables; D008137:Longitudinal Studies; D008297:Male; D017059:Models, Econometric; D011336:Probability; D013727:Terminal Care / Q000191:economics / Q000706:statistics & numerical data; D013997:Time Factors; D014852:Wales