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    Menec, V. H. Lix, L. Nowicki, S. and Ekuma, O. 2007. Health Care Use at the End of Life Among Older Adults: Does It Vary by Age?. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, Vol. 62, Issue. 4, p. 400.


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  • Canadian Journal on Aging / La Revue canadienne du vieillissement, Volume 17, Issue 2
  • January 1998, pp. 186-196

Age Differences in the Rates and Costs of Medical Procedures and Hospitalization during the Last Year of Life

  • Marie Demers (a1)
  • DOI: http://dx.doi.org/10.1017/S0714980800009259
  • Published online: 29 November 2010
Abstract
ABSTRACT

The aim of this study was to investigate the age differences in the rates and costs of broad categories of medical procedures (diagnostic, therapeutic and surgical) during the last year of life as well as hospitalization among the adult population of Quebec. The study is population-based and took into account 90 per cent of deaths occurring among the Quebec population (15 years and older) in 1991. The data were collected from the physician claim files of the Health Insurance Board. Costs were defined as physician payments for the procedures performed. The results showed that the rates of these procedures increase with age to reach a maximum in middle life and then decrease among the elderly. A similar trend was observed in the average cost of surgery and diagnostic procedures but the average cost of therapeutic procedures followed a constant decline with age. These data suggest that the oldest old do not seem to get more aggressive care at the end of life than younger decedents.

RÉSUMÉ

Cette étude examine les variations associées à l'âge dans la fréquence et le coût moyen des services diagnostiques, thérapeutiques et chirurgicaux dispensés durant la derniàre année de vie parmi la population adulte du Québec. Elle documente aussi l'hospitalisation durant la derniàre année de vie. Elle est basée sur 90 pour cent des décàs survenus au Québec en 1991 dans la population âgée de 15 ans ou plus. L'information provient des fichiers administratifs de la Régie de l'assurance-maladie, soit plus spécifiquement des demandes de paiement des médecins rémunérés à l'acte. Les coûts considérés sont les montants payés aux médecins pour les interventions réalisées. En ce qui a trait au taux d'utilisation de ces catégories de service, les résultats indiquent d'abord une augmentation avec l'âge atteignant un maximum parmi les adultes d'âge moyen et diminuant ensuite chez les personnes âgées. Une tendance similaire est observée pour le coût moyen de chirurgie et d'actes diagnostiques par usager. Pour sa part, le coût moyen des interventions thérapeutiques par usager est plus élevé chez les jeunes et subit une diminution constante avec l'âge. Ces données suggàrent que les personnes tràs âgées ne semblent pas plus soumises à des traitements intensifs au cours de la derniàre année de vie que les groupes d'âge plus jeunes.

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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

J. Lubitz , & G.F. Riley . (1993). Trends in medicare payments in the last year of life. New England Journal of Medicine, 328(15), 10921096.

N. McCall (1984). Utilization and costs of medicare services by beneficiaries in their last year of life. Medical Care, 22(A), 329342.

N.P. Roos , P. Montgomery , & L.L. Roos (1987). Health care utilization in the years prior to death. Milbank Quarterly, 65(2), 231254.

A.A. Scitovsky (1984). “The high cost of dying”: What do the data show? Milbank Quarterly, 62(4), 591608.

A.A. Scitovsky (1988). Medical care in the last twelve months of life: The relation between age, functional status, and medical care expenditures. Milbank Quarterly, 66(4), 640660.

A.A. Scitovsky (1994). “The high cost of dying” revisited. Milbank Quarterly, 72(4), 561591.

H. Temkin-Greener , M.R. Meiners , E.A. Petty , & J.S. Szydlowski (1992). The use and cost of health services prior to death: A comparison of the Medicare-only and the Medicare-Medicaid elderly populations. Milbank Quarterly, 70(4), 679701.

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Canadian Journal on Aging / La Revue canadienne du vieillissement
  • ISSN: 0714-9808
  • EISSN: 1710-1107
  • URL: /core/journals/canadian-journal-on-aging-la-revue-canadienne-du-vieillissement
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