Health Care Costs in the Last Week of Life

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Abstract
Health care expenditures in the United States exceeded $2 trillion in 2006 and are expected to rise rapidly during the next decade.1 A disproportionate share is spent at the end of life (EOL). Thirty percent of Medicare expenditures are attributable to 5% of beneficiaries who die each year2; about one-third of the expenditures in the last year of life is spent in the last month.3 Previous investigations have found that most of these costs result from life-sustaining care (eg, mechanical ventilator use and resuscitation), with acute care in the final 30 days of life accounting for 78% of costs incurred in the final year of life.4