Dying to pay: The cost of end-of-life care

The number of elderly Canadians is likely to double in 20 years, spurring a discussion of end-of-life care. We analyze the literature on the costs of this care and compare cost assessments of different models of palliative ca re. The cost of treatments for which there is little empirical support is f actored into our cost-savings analysis and the methodological limits of cos t-analysis studies are also discussed. We conclude that (a) depending upon the model of care, costs of end-of-rife care are considerable, (b) costs of care become more expensive with distance from the home setting, (c) cost s avings reported in palliative care settings may be a function of nearness t o death; (d) family expenses on end-of-life care are substantial and are no t factored into most cost-analysis studies, (e) a two-tiered system of pall iative home care allows families with higher incomes to afford help in supp orting home deaths, and (f) some treatments given to dying patients are cos tly while yielding little benefit.