ArticlePloS one2020
Health care expenditure in the last five years of life is driven by morbidity, not age: A national study of spending trajectories in Danish decedents over age 65.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Cardiovascular health, as per life's essential 8, and unhealthy aging trajectories.GeroScience · 2026Article
- Trajectories of health and social care expenditure in the last year of life among people 70 years and older in Region Stockholm: a population-based cohort study.BMC geriatrics · 2025Article
- Identifying clusters of healthcare expenditure trajectories in end-stage organ disease: a retrospective cohort study using linked administrative databases in Singapore.BMC health services research · 2025Article
- Healthcare Expenditure Trajectories in the Last 5 Years of Life: A Retrospective Cohort Study of Decedents with Advanced Cancer and End-Stage Organ Diseases.PharmacoEconomics - open · 2025Article
- Aging, longevity, and healthy aging: the public health approach.Aging clinical and experimental research · 2025Review
- Cause-specific mortality after spousal bereavement in a Danish register-based cohort.Scientific reports · 2025Article
- Medical expenses and its determinants in female patients with urological disorder.Cost effectiveness and resource allocation : C/E · 2024Article
- End-of-life expenditure on health care for the older population: a scoping review.Health economics review · 2024Article
- Determinants of public health expenditure in the EU.PloS one · 2024Article
- Article
- Addressing the Knowledge Deficit in Hospital Bed Planning and Defining an Optimum Region for the Number of Different Types of Hospital Beds in an Effective Health Care System.International journal of environmental research and public health · 2023Review
- Predicting mortality risk after a fall in older adults using health care spending patterns: a population-based cohort study.Age and ageing · 2023Article
- Examining annual transitions in healthcare spending among U.S. medicare beneficiaries using multistate Markov models: Analysis of medicare current beneficiary survey data, 2003-2019.Preventive medicine reports · 2023Article
- Predicting mortality and visualizing health care spending by predicted mortality in Danes over age 65.Scientific reports · 2023Article
- Machine learning models of healthcare expenditures predicting mortality: A cohort study of spousal bereaved Danish individuals.PloS one · 2023Article
- Sex differences in health care expenditures and mortality after spousal bereavement: A register-based Danish cohort study.PloS one · 2023Article
- Dynamical indicators in time series of healthcare expenditures predict mortality risk of older adults following spousal bereavement.BMC geriatrics · 2022Article
- Costs for Statutorily Insured Dental Services in Older Germans 2012-2017.International journal of environmental research and public health · 2021Article
- Tipping Points - Do the Prognostic Values of Multimorbidity and Functional Status Vary with Age?Clinical epidemiology · 2021Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe high level of medical spending at the end of life is well-documented, but whether there is any real potential for cost reductions there is still in question, and studies have tended to overlook the costs of care.
aimTo identify the most common health care spending trajectories over the last five years of life among older Danes, as well as the determinants of following a given trajectory.
methodsWe linked Danish health registries to obtain data on all health care expenditure (including hospital treatment, prescription drugs, primary care and costs of communal care) over the last five years of life for all Danish decedents above age 65 in the period 2013 through 2017. A latent class analysis identified the most common cost trajectories, which were then related to socio-economical characteristics and health status at five years before death.
resultsTotal health care expenditures in the last five years of life were largely independent of age and cause of death. Costs of home care and residential care increased steeply with age at death whereas hospital costs decreased correspondingly. We found four main spending trajectories among decedents: 3 percent followed a late-rise trajectory, 11 percent had accelerating costs, and two groups of 43 percent each followed moderately or consistently high trajectories. The main predictor of total expenditure was the number of chronic diseases.
interpretationSpending at the end of life is largely determined by chronic disease, and age and cause of death only determine the distribution of expenses into care and cure.
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