Kasteridis, Panagiotis orcid.org/0000-0003-1623-4293, Rice, Nigel orcid.org/0000-0003-0312-823X and Santos, Rita orcid.org/0000-0001-7953-1960 (2022) Heterogeneity in end of life health care expenditure trajectory profiles. Journal of Economic Behavior and Organization. pp. 221-251. ISSN 0167-2681
Abstract
Treatment at the end of life forms a major component of aggregate health care expenditure. Expenditure, however, begins to increase several years before death and varies substantially across individuals. This paper investigates heterogeneity in expenditure profiles across a 36 month period preceding death using group-based trajectory models. A mixture of generalised linear models with four components fits the data best, and identifies decedents in to high cost late rise, medium-high cost late rise, medium-low cost, and low cost late rise expenditure profiles. Approximately 35% of the sample is allocated to the high cost late rise trajectory with average monthly expenditure of £493 36 months prior to death rising linearly for about 28 months before exponential growth to £4,000 in the month preceding death. Health conditions at the beginning of the period increase the risk of being in a higher cost trajectory with cancer having the largest impact. The existence of concurrent morbidities substantially raises the probability of membership to the high-cost late rise profile group. A better understanding of the determinants of expenditure profiles in the run up to death contributes to informing policies aimed at mitigating costs while not compromising quality of care.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2022 The Author(s) |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Social Sciences (York) > Centre for Health Economics (York) The University of York > Faculty of Social Sciences (York) > Economics and Related Studies (York) |
Funding Information: | Funder Grant number POLICY RESEARCH PROGRAMME CENTRAL COMMISSIONING FACILITY PR-PRU-1217-20301 |
Depositing User: | Pure (York) |
Date Deposited: | 14 Oct 2022 08:40 |
Last Modified: | 28 Dec 2024 00:12 |
Published Version: | https://doi.org/10.1016/j.jebo.2022.10.017 |
Status: | Published online |
Refereed: | Yes |
Identification Number: | 10.1016/j.jebo.2022.10.017 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:192111 |
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Description: Heterogeneity in end of life health care expenditure trajectory profiles
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