The Best Place to Die — Financially Speaking

Posted on | November 21, 2006 | Comments Off on The Best Place to Die — Financially Speaking

The United States spent $327 billion last year on Medicare. That amount startles some. But what is more striking is that 27% of that, some $88 billion, was spent on the care of patients in their last year of life.

Now Dartmouth Medical School, the home of the original Jack Wennberg variability studies in the 1980s, has taken a look at the numbers — and the results are raising eyebrows. Released in October of this year in the Dartmouth Atlas of Health Care, the study looks at the average cost of doctor and hospital care during the last six months of life in Medicare patients with chronic illness in 309 regions.

The highest cost? Manhattan at $35,838. The lowest? Wichita Falls, Texas, at $10,913. What’s driving this 3-fold variability? According to a USA Today article, experts say three things. First, capacity studies show the more hospital beds and specialists in a region, the more hospitalization, diagnostic tests and procedures. Second, patient preferences. There’s a clear connection between demand and consumption. And third, physician practice patterns.

We all have to die, but apparently how much it will cost us in our final months varies considerably. If you want to spend a lot, try New York, New Jersey, Connecticut, Massachusetts, Maryland, D.C., California or Hawaii. If you want to spend less, try West Virginia, Indiana, Iowa, North or South Dakota, Wyoming, Montana, Idaho, Utah or New Mexico.