IMPLICATIONS OF THE COST OF END OF LIFE CARE

INTRODUCTION

BACKGROUND OF STUDY

Health care is an economic quantity that is different from most other goods. Access to and receiving health care could mean the difference between life and death. While health care is necessary throughout life, it becomes inevitable at the end of life. End of life itself has been defined as both a “state” (Riley and Lubitz (2010)) and a “stage” (Crippen and Barnato (2011), Bach (2011), Bach, Schrag and Begg (2004)). End of life care is extremely personal, expensive and complex as it impacts not only individuals, but their families and society in general Objective.

The objective of this project is to summarize the existing literature on end of life issues of interest to actuaries, and to document a broad list of such articles. The end of life issues explored are multi-dimensional and from multiple perspectives. When considering cost implications of end of life care, it is necessary to consider cost in a broad context as it is a measure that cannot solely be defined by dollars. Other dimensions of cost, such as quality of care, family caregiving, communication, patient preferences and access to care, should also be explored. Researchers While we, Drs. Martin Halek and Marjorie Rosenberg, were the primary researchers on this project, we were significantly aided by the efforts of two actuarial science students, Jimmy Conway and Vignesh Valliappan.

Acknowledgements

We acknowledge support from the Health Section Research Committee of the Society of Actuaries for this research. We are grateful to the following members of the Project Oversight Group for their comments and suggestions: Russell Hendel, Prashant Nayak, Jeff Petertil, Brent Reis, Tim Rice, Tia Sawhney, Steve Siegel, David Strey and Sara Teppema. We also thank Barbara Scott from the Society of Actuaries for her assistance.

Methods/Process