Medical care in the last twelve months of life: the relation between age, functional status, and medical care expenditures

Milbank Q. 1988;66(4):640-60.


Medical care expenditures of a group of decedents during their last year of life suggest that high-technology medical services may be allocated most rationally than is generally assumed. Patients who received intensive hospital and physician services were largely the "young old," aged 65 to 79 years with good functional status, while the frail "older old," aged 80 years and over, received largely supportive care. Total care expenses of the older old were only slightly below those of the most expensive decedents, however, as expenses for nursing home and home health care more than offset lower medical service expenses. Further studies are needed before concluding that the major cause of high costs at teh end of life is the inappropriate use of high-technology care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • California
  • Cause of Death
  • Female
  • Health Expenditures / statistics & numerical data*
  • Health Services / statistics & numerical data*
  • Health Status*
  • Health*
  • Home Care Services
  • Humans
  • Male
  • Middle Aged
  • Patient Selection*
  • Resource Allocation*
  • Retrospective Studies
  • Technology, High-Cost / supply & distribution
  • Withholding Treatment