• Michael Misialek, MD

The Cost of Advanced Illness and End of Life Care

In the July issue of Health Affairs examined the costs associated with end of life care. The authors discuss the following major findings.

The US leads the world in costs of end of life care, with an average per capita cost of $80,000. Approximately 10% of spending occurs in the last 12 months of life. Hospital spending accounts for more than 40% of total cost. The majority of costs occur due to chronic illness care.

Only one third of Americans complete advance care directives. The authors found no change in this rate during recent years. They stress that advance care directives, being a major metric for high quality end of life care, should be a top priority in planning.

A disparity of care exists with Black and Hispanic patients often receiving care from lower quality hospice programs. These patients are also less likely to receive culturally appropriate emotional and spiritual support.

End of life caregivers provide almost twice the amount care than others. These include family friends who are unpaid. There must be expanded access to support services for family and friends.

#costsofcare #endoflifecare #advancedirectives

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