Home > Publications . Search All . Browse All . Country . Browse PSC Pubs . PSC Report Series

PSC In The News

RSS Feed icon

H. Luke Shaefer and colleagues argue for a universal child allowance

Hindustan Times points out high value of H-1B visas for US innovation, welfare, and tech firm profits

Novak, Geronimus, Martinez-Cardoso: Threat of deportation harmful to immigrants' health

More News

Highlights

Heather Ann Thompson wins Pulitzer Prize for book on Attica uprising

Lam explores dimensions of the projected 4 billion increase in world population before 2100

ISR's Nick Prieur wins UMOR award for exceptional contribution to U-M's research mission

How effectively can these nations handle outside investments in health R&D?

More Highlights

Next Brown Bag

Mon, April 10, 2017, noon:
Elizabeth Bruch

Lauren Nicholas photo

Regional Variation in the Association Between Advance Directives and End-of-Life Medicare Expenditures

Publication Abstract

Nicholas, Lauren, Kenneth M. Langa, Theodore J. Iwashyna, and David Weir. 2011. "Regional Variation in the Association Between Advance Directives and End-of-Life Medicare Expenditures." JAMA, 306(13): 1447-1453.

This study examined regional variation in the associations between treatment-limiting advance directive use, end-of-life Medicare expenditures, and use of palliative and intensive treatments. Researchers used prospectively collected survey data from the Health and Retirement Study for 3,302 Medicare beneficiaries who died between 1998 and 2007, linked to Medicare claims and the National Death Index. Results indicate that advance directives specifying limitations in end-of-life care were associated with significantly lower levels of Medicare spending, lower likelihood of in-hospital death, and higher use of hospice care in regions characterized by higher levels of end-of-life spending. Specifically, (1) advance directives specifying limits in care were associated with lower spending in hospital referral regions with high average levels of end-of-life expenditures, but there was no difference in spending in hospital referral regions with low or medium levels of end-of-life expenditures; (2) directives were associated with lower adjusted probabilities of in-hospital death in high- and medium-spending regions; and (3) directives were associated with higher adjusted probabilities of hospice use in high- and medium-spending regions, but not in low-spending regions.

DOI:10.1001/jama.2011.1410 (Full Text)

PMCID: PMC3332047. (Pub Med Central)

Country of focus: United States of America.

Browse | Search : All Pubs | Next