Inpatient Expenditure of the Decedent Elderly in Japan.

ABSTRACT

End-of-life healthcare expenditure has much to do with the Japanese Government’s policies of promoting integrated care in communities and promoting end-of-life care at home or at nursing homes rather than at hospitals. We analyzed healthcare expenditure for decedent elderly during the one year prior to death, focusing on inpatient expenditure and place of death as well as differences between males and females. The share of inpatient expenditure was 78 percent for the decedent elderly as a whole, compared to 45 percent for the whole elderly population. Monthly inpatient expenditure of those decedent elderly who received inpatient care consecutively in the final 4 months, increased gradually as death month approached for each age group. However, a sharp increase was found in only a small portion of this group. Place of death was quite related to the healthcare expenditure during the one year prior to death, and frequency of inpatient care use in the final year is as important as place of death in determining the level of healthcare expenditure.