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Cited by 335Palliative Care and End-of-Life IssuesHealthcare Policy and ManagementHealthcare cost, quality, practices

The Economics of Dying -- The Illusion of Cost Savings at the End of Life

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Emanuel, Ezekiel J., Emanuel, Linda L.·1994·New England Journal of Medicine
DOI 10.1056/nejm199402243300806
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Abstract

For more than a decade, health policy analysts have noted -- and some have decried -- the high cost of dying1–7. With the acceleration of pressures on health care costs and calls for reform, considerably more attention has been focused on proposals to control costs at the end of life8. One proposal would require persons enrolling in a health care plan to complete an advance directive9,10. Others would require hospitals to establish guidelines to identify and reduce futile care11–13. Similar ideas have been expressed by members of President Bill Clinton's Health Care Task . . .

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  • In other serious illnesses, hospice users and their families report better symptom control and greater satisfaction with dying.

    “in other life-threatening illnesses, users of hospice care and their families report improved symptom control and a high level of satisfaction with the dying process [12].”

    From Should there be an expanded role for palliative care in end-stage renal disease? (2010) · cites this paper as [12]

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Research works printed but not linked: 7

  1. [3]3. Ginzberg E. The high costs of dying. Inquiry 1980;17:293-5.
  2. [18]18. Siu AL, Brook RH. Allocating health care resources: how can we ensure access to essential care? In: Ginzberg E, ed. Medicine and society: clinical decisions and societal values. Boulder, Colo.: Westview Press, 1987:2033.
  3. [21]21. Teno J, Lynn J, Phillips R, et al. Do advance directives save resources? Clin Res 1993;41:551A. abstract.
  4. [25]25. Hannan EL, O'Donnell JF. An evaluation of hospices in the New York State Hospice Demonstration Program. Inquiry 1984;21:338-48.
  5. [24]24. Spector WD, Mor V. Utilization and charges for terminal cancer patients in Rhode Island. Inquiry 1984;21:328-37.
  6. [27]27. Brooks CH, Smyth-Staruch K. Hospice home care cost savings to thirdparty insurers. Med Care 1984;22:691-703.
  7. [41]41. Riley G, Lubitz J, Prihoda R, Rabey E. The use and costs of Medicare services by cause of death. Inquiry 1987;24:233-44.

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Authors
Emanuel, E. J., & Emanuel, L. L.
Affiliations
Harvard University (US)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1994-02-24
Volume
330
Issue
8
Pages
540-544
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm199402243300806
OpenAlex
W2314987647
Cited by
335
References
51
Citations by year
2025: 2 · 2024: 2 · 2023: 4 · 2022: 5 · 2021: 8 · 2020: 7 · 2019: 4 · 2018: 3 · 2017: 8 · 2016: 7 · 2015: 11 · 2014: 9 · 2013: 10 · 2012: 7
FWCI
9.99
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
  • Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
Keywords
end-of-life care, health care costs, cost reduction, advance directives, futility, health care cost containment, health policy, terminal illness
MeSH terms
Aged, Health Expenditures, Medicare, Health Services Research, Home Care Services, Hospitalization, Humans, United States, Advance Directives, Treatment Outcome, Cost Savings, Hospice Care

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