Profiles of Older Medicare Decedents
Article first published online: 18 JUL 2002
Journal of the American Geriatrics Society
Volume 50, Issue 6, pages 1108–1112, June 2002
How to Cite
Lunney, J. R., Lynn, J. and Hogan, C. (2002), Profiles of Older Medicare Decedents. Journal of the American Geriatrics Society, 50: 1108–1112. doi: 10.1046/j.1532-5415.2002.50268.x
- Issue published online: 18 JUL 2002
- Article first published online: 18 JUL 2002
- end of life;
- terminal care;
- health expenditures;
OBJECTIVES: To evaluate the usefulness of a clinical scheme to classify older decedents to better understand the issues associated with healthcare use and costs in the last year of life.
DESIGN: We analyzed Medicare claims data for a random sample of 0.1% of all Medicare beneficiaries with expenditures between 1993 and 1998. This sample yielded 7,966 deaths.
SETTING: Medicare claims data.
PARTICIPANTS: Medicare beneficiaries.
MEASUREMENTS: We classified decedents into groups representing four trajectories at the end of life: sudden death, terminal illness, organ failure, and frailty.
RESULTS: Ninety-two percent of decedents were captured by the profiling strategy. The four trajectory groups had distinct patterns of demographics, care delivery, and Medicare expenditures. Frailty was a dominant pattern, with 47% of all decedents, whereas sudden death claimed only 7%; cancer claimed 22%, and organ system failure, 16%.
CONCLUSIONS: The clinical scheme to classify decedents appears to fit most decedents and to form groups with substantial clinical differences. Acknowledging the differences among these groups may be a fruitful way to evaluate expenditures and develop strategies to improve care at the end of life.