The study, published last week in The New Zealand Medical Journal, used linked health datasets to look at how health system expenditure varied by age and whether people were within six or 12 months of death.
The study found that someone dying at age 70 would have received $113,000 of New Zealand publicly-funded health services over their life, compared with someone dying at age 90 having received $220,000 of services.
It is commonly stated that around 25% of health spending is in the last six months of life, commented lead author Professor Tony Blakely, from the University of Otago, Wellington.
“However, what we have found is that over the lifespan of a Kiwi citizen it was only in excess of 25% for deaths up to age 50. The vast majority of deaths occur at older ages.”
For someone dying at age 80, of all the public spending on them over their life ‘only’ 11% was estimated to be in the last year of life, Professor Blakely says.
“Given that there is concern that spending in the last year of life may not be the best use of resources, it looks like New Zealand is doing fairly well in this respect.”
Professor Blakely adds: “The allocation of public funds to health services needs constant public debate, balancing the maximisation of health gains for each dollar spent against other values such as fairness, or the right to dignified death.”
Savings in health spending could be made at the end of life through the likes of advanced care plans – which may also increase quality of life near death, eg by avoiding interventions such as surgery that might only gain a few weeks or months of life.
For further details visit the website of the University of Otago, Wellington, or subscribers can access the journal article ‘Health system costs by sex, age and proximity to death, and implications for estimation of future expenditure’ on the The New Zealand Medical Journal website. Professor Blakely has also written a blog about the study.
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