What is Known About the Economics of End-of-Life Care for Medicare Beneficiaries?

PURPOSE: This article reviews the state of science on the economics of end-of-life care for Medicare beneficiaries and outlines the research needed to fill gaps in that literature. DESIGNS AND METHODS: Searches of the medical, health services, and economics literature were conducted. Key topics examined were studies of spending on end-of-life care and financial, organizational, and nonfinancial barriers to high-quality end-of-life care. RESULTS: Studies have documented poor quality of care, dissatisfaction with care, and limitations in the coverage of end-of-life care for Medicare beneficiaries. However, critical gaps in our knowledge about how to design a better end-of-life care system for Medicare beneficiaries remain. IMPLICATIONS: Further research on how treatment decisions at the end of life are made and prospective studies of costs, satisfaction, and outcomes are needed. (October 2002)