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End-Of-Life Medical Spending In Last Twelve Months Of Life Is Lower Than Previously Reported.

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TLDR
In all nine countries, medical spending at the end of life was high relative to spending at other ages, and high aggregate medical spending is due not to last-ditch efforts to save lives but to spending on people with chronic conditions, which are associated with shorter life expectancies.
Abstract
Although end-of-life medical spending is often viewed as a major component of aggregate medical expenditure, accurate measures of this type of medical spending are scarce. We used detailed health care data for the period 2009–11 from Denmark, England, France, Germany, Japan, the Netherlands, Taiwan, the United States, and the Canadian province of Quebec to measure the composition and magnitude of medical spending in the three years before death. In all nine countries, medical spending at the end of life was high relative to spending at other ages. Spending during the last twelve months of life made up a modest share of aggregate spending, ranging from 8.5 percent in the United States to 11.2 percent in Taiwan, but spending in the last three calendar years of life reached 24.5 percent in Taiwan. This suggests that high aggregate medical spending is due not to last-ditch efforts to save lives but to spending on people with chronic conditions, which are associated with shorter life expectancies.

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Journal ArticleDOI

Waste in the US Health Care System: Estimated Costs and Potential for Savings.

TL;DR: The estimated cost of waste in the US health care system ranged from $760 billion to $935 billion, accounting for approximately 25% of total health care spending, and the projected potential savings from interventions that reduce waste, excluding savings from administrative complexity, ranged from £191 billion to £282 billion, representing a potential 25% reduction in the total cost of Waste.
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Health care expenditures, age, proximity to death and morbidity: Implications for an ageing population

TL;DR: It is shown that HCE is principally determined by proximity todeath rather than age, and that proximity to death is itself a proxy for morbidity.
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Report of the Lancet Commission on the Value of Death: bringing death back into life

- 01 Feb 2022 - 
TL;DR: The authors of as discussed by the authors proposed five principles of a new vision of a sustainable and sustainable future for the care of the dying in high-income countries, and increasingly in low-and-middle income countries.
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Identifying the Population with Serious Illness: The “Denominator” Challenge

TL;DR: To ensure seriously ill people and their families receive high-quality primary and specialty palliative care services, rigorous methods are needed to prospectively identify this population of patients and caregivers.
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Predictive modeling of U.S. health care spending in late life.

TL;DR: Analyzing how spending is distributed by predicted mortality in the United States is analyzed, based on a machine-learning model of annual mortality risk built using Medicare claims, to suggest that spending on the ex post dead does not necessarily mean that the ex ante “hopeless” spending is spent.
References
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Journal ArticleDOI

Early Palliative Care for Patients with Metastatic Non–Small-Cell Lung Cancer

TL;DR: Among patients with metastatic non-small-cell lung cancer, early palliative care led to significant improvements in both quality of life and mood and, as compared with patients receiving standard care, patients received less aggressive care at the end of life but longer survival.
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Change in End-of-Life Care for Medicare Beneficiaries: Site of Death, Place of Care, and Health Care Transitions in 2000, 2005, and 2009

TL;DR: Among Medicare beneficiaries who died in 2009 and 2005 compared with 2000, a lower proportion died in an acute care hospital, although both ICU use and the rate of health care transitions increased in the last month of life.
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Ageing of population and health care expenditure: a red herring?

TL;DR: The limited impact of age on HCE suggests that population ageing may contribute much less to future growth of the health care sector than claimed by most observers.
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It’s The Prices, Stupid: Why The United States Is So Different From Other Countries

TL;DR: The data show that the United States spends more on health care than any other country, however, on most measures of health services use, theUnited States is below the OECD median.
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Association between advance directives and quality of end-of-life care: a national study.

TL;DR: The role of advance directives 10 years after the Patient Self‐Determination Act is examined to examine the role of ADs.
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