Costs in the last year of life in the Netherlands

The costs of health care in the last year of life are a subject of debate a nd myth. Expensive interventions at the end of life often are blamed for th e vapid increase in health care spending but evidence about the existence o f such exceptionally high expenditures at the end of life is rare and fault y. This investigation examines the development and composition of health ca re costs at the end of life for all age groups in The Netherlands. In contr ast with earlier studies, this research analyzes both acute care (cure) and long-term care (care) costs. As an alternative for the frequently used con cept of calendar years, we employed the concept of life years for calculati ng the costs at the end of Life. We found that when life approaches its end health care expenditures indeed vise sharply, especially in the last month s. However when we compared total cure costs in the last year of life to th e total cure costs for the entire population, we concluded that the end-of- life shave was only about 10%. Results of this study show that intervention s to reduce costs in the last year of life will have only a modest impact c ompared to the total health care budget.