Hello,

We noticed you're browsing in private or incognito mode.

To continue reading this article, please exit incognito mode or log in.

Not a subscriber? Subscribe now for unlimited access to online articles.

Photo of a hospital hallway.
  • Naoki Takano | Flickr
  • Medicare myth

    Spending is mostly not being wasted on futile end-of-life care.

    Around 25 percent of US Medicare spending occurs in the last year of life. Does that mean society is throwing large amounts of medical treatment at some patients in a futile, if noble, effort to extend lives that are bound to end soon?

    A study coauthored by economics professor Amy Finkelstein offers a resounding answer: No.

    This story is part of the September/October 2018 Issue of the MIT News magazine
    See the rest of the issue
    Subscribe

    After examining millions of medical records, the researchers found that although Medicare spending is concentrated among people who end up dying, little of it goes to patients whose death within the year was judged highly likely. For example, less than 5 percent is applied to patients in the single highest-risk percentile—and their predicted one-year mortality rate is still just 46 percent.

    “Very little money is spent on people who we know with high probability are going to die in a short amount of time,” says Finkelstein.

    The study used machine learning to evaluate the impact of a range of variables, producing a probability of death within one year for each patient. It revealed that fewer than 10 percent of people who die in a given year have a predicted one-year mortality rate over 50 percent. And even when people are admitted to a hospital in their last year of life, fewer than 4 percent have a predicted one-year mortality rate of 80 percent or higher at the time of admission.

    The study shows that even relatively low-mortality health scenarios for the elderly will include some deaths—not that individual treatment decisions represent long-shot cases.

    Become an MIT Technology Review Insider for in-depth analysis and unparalleled perspective.

    Subscribe today
    Photo of a hospital hallway.
    Next in MIT News
    Want more award-winning journalism? Subscribe to Print + All Access Digital.
    • Print + All Access Digital {! insider.prices.print_digital !}*

      {! insider.display.menuOptionsLabel !}

      The best of MIT Technology Review in print and online, plus unlimited access to our online archive, an ad-free web experience, discounts to MIT Technology Review events, and The Download delivered to your email in-box each weekday.

      See details+

      12-month subscription

      Unlimited access to all our daily online news and feature stories

      6 bi-monthly issues of print + digital magazine

      10% discount to MIT Technology Review events

      Access to entire PDF magazine archive dating back to 1899

      Ad-free website experience

      The Download: newsletter delivery each weekday to your inbox

      The MIT Technology Review App

    /3
    You've read of three free articles this month. for unlimited online access. You've read of three free articles this month. for unlimited online access. This is your last free article this month. for unlimited online access. You've read all your free articles this month. for unlimited online access. You've read of three free articles this month. for more, or for unlimited online access. for two more free articles, or for unlimited online access.