Healthcare costs could total more than household assets for elderly at end of life

By Sarah Guy, medwireNews Reporter

For more than 25% of elderly US citizens, healthcare costs incurred during the last 5 years of life will amount to more than their total household assets, show data reported in the Journal of General Internal Medicine.

Average out-of-pocket expenses during this period were US$ 38,688 (€ 29,956) for individual participants of the US Health and Retirement Study who died during 2002 to 2008, and $ 51,030 (€ 39,514) for their peers who were part of a couple in which one spouse died.

"The Medicare program provides nearly universal health care coverage to the population aged 65 years or older," explain Amy Kelley (Mount Sinai School of Medicine, New York, USA) and colleagues.

However: "Medicare does not cover a variety of services particularly valuable for those with chronic diseases or a life-limiting illness, including most eye glasses, hearing aids, homecare services and equipment, and non-rehabilitative nursing home care," they add.

The team reports that more than three-quarters of households spent at least $ 10,000 (€ 7745) during the 5-year period before death, and as a proportion of overall wealth; a quarter of the participants' spending exceeded total household assets.

A small group of participants (10%) who were survived by a spouse spent 100% or more of their total household assets, while a third (35%) of unmarried individuals spent this much.

The dataset included details for 3209 individuals aged at least 70 years and whose 5-year "lookback" did not go before 1998, write Kelley and co-investigators.

They observed that the highest out-of-pocket spending was associated with individuals affected by dementia, with a mean $ 66,155 (€ 51,245) spent among those with Alzheimer's disease compared with a mean $ 31,069 (€ 24,067) spent by those with gastrointestinal and liver disease.

"Thus, advanced dementia represents an additional and unavoidable financial risk, creating further challenges for aging baby-boomers seeking to save against future health costs," remark the authors.

While increases in healthcare spending created by an aging population and an increasing prevalence of debility and dementia are predicted, it remains to be seen whether results like those from this study will create renewed interest in a publicly sponsored long-term care program, conclude Kelley et al.

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