Thesis Abstract

Abstract
End of life care is a critical aspect of healthcare that often comes with significant financial implications. This research project aims to explore the various implications of the cost of end of life care on individuals, families, healthcare systems, and society as a whole. The rising costs of end of life care have become a major concern globally, with studies indicating that a significant portion of healthcare expenses are incurred during this period. The implications of these costs are multifaceted. For individuals and families, the financial burden of end of life care can be overwhelming, potentially leading to financial strain, depletion of savings, and even bankruptcy. This can have long-lasting effects on the financial well-being and quality of life of the surviving family members. In addition, the high costs of end of life care may also influence treatment decisions, with some individuals opting for less aggressive or lower-cost care due to financial constraints. On a broader scale, the cost of end of life care has significant implications for healthcare systems and society. Healthcare systems may struggle to allocate resources efficiently, especially when faced with limited funding and competing healthcare priorities. The rising costs of end of life care can also impact healthcare access and equity, as individuals from lower socioeconomic backgrounds may face barriers to accessing quality end of life care due to financial constraints. Moreover, the cost of end of life care can have broader societal implications, including economic impacts and ethical considerations. The economic burden of end of life care can strain government budgets and contribute to rising healthcare expenditures, potentially affecting overall healthcare sustainability. Ethically, the high costs of end of life care raise questions about resource allocation, distributive justice, and the prioritization of healthcare spending. Overall, understanding the implications of the cost of end of life care is essential for policymakers, healthcare providers, and society as a whole. Addressing the financial implications of end of life care requires a comprehensive approach that considers the needs of individuals, families, healthcare systems, and society. By exploring these implications, this research project aims to contribute to the ongoing dialogue on end of life care and inform strategies to improve the affordability and accessibility of quality care for individuals at the end of life.

Thesis Overview

INTRODUCTION

BACKGROUND OF STUDY

Health care is an economic quantity that is different from most other goods. Access to and receiving health care could mean the difference between life and death. While health care is necessary throughout life, it becomes inevitable at the end of life. End of life itself has been defined as both a “state” (Riley and Lubitz (2010)) and a “stage” (Crippen and Barnato (2011), Bach (2011), Bach, Schrag and Begg (2004)). End of life care is extremely personal, expensive and complex as it impacts not only individuals, but their families and society in general Objective.

The objective of this project is to summarize the existing literature on end of life issues of interest to actuaries, and to document a broad list of such articles. The end of life issues explored are multi-dimensional and from multiple perspectives. When considering cost implications of end of life care, it is necessary to consider cost in a broad context as it is a measure that cannot solely be defined by dollars. Other dimensions of cost, such as quality of care, family caregiving, communication, patient preferences and access to care, should also be explored. Researchers While we, Drs. Martin Halek and Marjorie Rosenberg, were the primary researchers on this project, we were significantly aided by the efforts of two actuarial science students, Jimmy Conway and Vignesh Valliappan.

Acknowledgements

We acknowledge support from the Health Section Research Committee of the Society of Actuaries for this research. We are grateful to the following members of the Project Oversight Group for their comments and suggestions: Russell Hendel, Prashant Nayak, Jeff Petertil, Brent Reis, Tim Rice, Tia Sawhney, Steve Siegel, David Strey and Sara Teppema. We also thank Barbara Scott from the Society of Actuaries for her assistance.

Methods/Process