Regional variation in the association between advance directives and end-of-life Medicare expenditures.

ABSTRACT:

Context

It is unclear if advance directives (living wills) are associated with end-of-life expenditures and treatments.

Objective

To examine regional variation in the associations between treatment-limiting advance directive use, end-of-life Medicare expenditures, and use of palliative and intensive treatments.

Design, setting, and patients

Prospectively collected survey data from the Health and Retirement Study for 3302 Medicare beneficiaries who died between 1998 and 2007 linked to Medicare claims and the National Death Index. Multivariable regression models examined associations between advance directives, end-of-life Medicare expenditures, and treatments by level of Medicare spending in the decedent's hospital referral region.

Main outcome measures

Medicare

SUBMITTER: Nicholas LH 

PROVIDER: S-EPMC3332047 | biostudies-literature | 2011 Oct

REPOSITORIES: biostudies-literature