Riley G, Lubitz J, Prihoda R, Rabey E
Office of Research, HCFA, Baltimore, MD 21207.
Inquiry. 1987 Fall;24(3):233-44.
The high costs and difficult ethical and medical issues often associated with care of the dying are of special interest to the Medicare program, because enrollees in their last year of life account for over one-fourth of total Medicare expenditures. In this study, we look at those costs by cause of death for aged Medicare beneficiaries who died in 1979. We found that expenditures varied markedly by cause of death. Cancer was the most expensive leading cause of death, with per capita expenses of $8,021, compared with $4,012 for heart disease. Because of the greater number of deaths from heart disease, expenses for heart disease decedents accounted for 8.2% of the total Medicare budget in 1979 compared with 7.2% for cancer. These data provide a baseline with which to evaluate the effects of major changes in Medicare on care for the dying.
临终护理常常涉及高昂的费用以及棘手的伦理和医学问题，医疗保险计划对这些问题尤为关注，因为参保者生命的最后一年所产生的费用占医疗保险总支出的四分之一以上。在本研究中，我们考察了1979年去世的老年医疗保险受益人的死因相关费用。我们发现，费用因死因不同而有显著差异。癌症是最昂贵的主要死因，人均费用为8,021美元，而心脏病的人均费用为4,012美元。由于心脏病导致的死亡人数更多，1979年心脏病死者的费用占医疗保险预算总额的8.2%，而癌症患者的费用占比为7.2%。这些数据提供了一个基线，用以评估医疗保险的重大变革对临终护理的影响。
