Project Abstract

Abstract
The cost of end-of-life care has significant implications for individuals, families, healthcare systems, and society as a whole. This research project aims to explore the various dimensions of these implications, including financial, ethical, and emotional aspects. The rising costs of end-of-life care are a major concern globally, with studies showing that a significant portion of healthcare expenditures is allocated to patients in the final stages of life. This has led to discussions about the sustainability of healthcare systems and the need for more efficient allocation of resources. Financial implications of end-of-life care include the burden on individuals and families, as well as the strain on public and private healthcare budgets. High costs can lead to financial hardship for families, impacting their quality of life and potentially leaving them in debt. Healthcare systems face challenges in balancing the need to provide quality end-of-life care with limited resources, leading to difficult decisions about resource allocation. Ethical considerations are also central to the discussion of end-of-life care costs. Questions about the value of prolonging life at any cost, the importance of quality of life in healthcare decision-making, and the equitable distribution of resources among patients are all important ethical dilemmas. Balancing the ethical principles of beneficence, autonomy, and justice in the context of end-of-life care is a complex and challenging task that requires careful consideration. The emotional implications of end-of-life care costs are profound, affecting patients, families, and healthcare providers. Patients facing high costs may experience stress, anxiety, and fear about the financial burden they are placing on their loved ones. Families may feel guilt, sadness, and frustration as they navigate difficult decisions about care and finances. Healthcare providers also face emotional challenges, grappling with the ethical dilemmas of resource allocation and the emotional toll of caring for patients at the end of life. In conclusion, the implications of the cost of end-of-life care are far-reaching and multifaceted. By understanding and addressing the financial, ethical, and emotional dimensions of these implications, policymakers, healthcare providers, and society as a whole can work towards more sustainable and compassionate end-of-life care practices.

Project 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