Long‐Term Trends in Medicare Payments in the Last Year of Life

Health Services Research - Tập 45 Số 2 - Trang 565-576 - 2010
Gerald F. Riley1, James Lubitz2
1Office of Research Development and Information, Centers for Medicare and Medicaid Services, 7500 Security Blvd., Mail Stop C3-21-28, Baltimore, MD 21244
2Division of Analysis and Epidemiology, National Center for Health Statistics.

Tóm tắt

Objective. To update research on Medicare payments in the last year of life.

Data Sources. Continuous Medicare History Sample, containing annual summaries of claims data on a 5 percent sample from 1978 to 2006.

Study Design. Analyses were based on elderly beneficiaries in fee for service. For each year, Medicare payments were assigned either to decedents (persons in their last year) or to survivors (all others).

Results. The share of Medicare payments going to persons in their last year of life declined slightly from 28.3 percent in 1978 to 25.1 percent in 2006. After adjustment for age, sex, and death rates, there was no significant trend.

Conclusions. Despite changes in the delivery of medical care over the last generation, the share of Medicare expenditures going to beneficiaries in their last year has not changed substantially.

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Tài liệu tham khảo

10.1001/jama.292.22.2765

10.1111/j.1475-6773.2004.00232.x

10.1093/geront/42.suppl_3.40

Bureau of Labor Statistics.2008. “Updated CPI‐U‐RS All Items and All Items Less Food and Energy 1978–2007[accessed on August 12 2008]. Available athttp://stats.bls.gov/cpi/cpiurs1978_2007.pdf

Calfo S. J.Smith andM.Zezza.2008. “Last Year of Life Study[accessed on August 11 2008]. Available athttp://www.cms.hhs.gov/ActuarialStudies/downloads/Last_Year_of_Life.pdf

10.1377/hlthaff

Earle C. C., 2004, Trends in the Aggressiveness of Cancer Care near the End‐of‐Life, Journal of Clinical Oncology, 22, 315, 10.1200/JCO.2004.08.136

10.1056/NEJM199402243300806

Federal Interagency Forum on Aging‐Related Statistics., 2008, Older Americans 2008: Key Indicators of Well‐Being. Federal Interagency Forum on Aging‐Related Statistics

10.1016/S0167-6296(00)00039-4

Garber A. M., 1998, Frontiers in the Economics of Aging, 247

Garber A. M., 1999, Frontiers in Health Policy Research, 77

10.1258/135581907780279585

10.1377/hlthaff.20.4.188

10.1111/1475-6773.01113

10.1007/s11606-008-0638-5

10.1001/jama.286.11.1349

Liu K., 2006, End‐of‐Life Medicare and Medicaid Expenditures for Dually Eligible Beneficiaries, Health Care Financing Review, 27, 95

Lubitz J., 1984, The Use and Costs of Medicare Services in the Last 2 Years of Life, Health Care Financing Review, 5, 117

10.1056/NEJM199304153281506

10.1016/S1070-3241(00)26020-3

Medicare Payment Advisory Commission.1999.Improving Care at the End‐of‐Life. Report to the Congress: Selected Medicare issues. Washington DC pp. 117–32.

Medicare Payment Advisory Commission.2008.Report to the Congress: Reforming the Delivery System. Washington DC pp. 203–40.

Riley G., 1987, The Use and Costs of Medicare Services by Cause of Death, Inquiry, 24, 233

10.2307/3350356

10.1136/bmj.a1720

10.1056/NEJM200005113421906

10.5034/inquiryjrnl_38.1.73

The SUPPORT Principal Investigators., 1995, A Controlled Trial to Improve Care for Seriously Ill Hospitalized Patients, Journal of the American Medical Association, 274, 1591, 10.1001/jama.1995.03530200027032

10.1001/jama.291.1.88

10.1377/hlthaff.25

10.1136/bmj.328.7440.607

10.1056/NEJMp0808003