The use and costs of Medicare services by cause of death.

The high costs and difficult ethical and medical issues often associated with care of the dying are of special interest to the Medicare program, because enrollees in their last year of life account for over one-fourth of total Medicare expenditures. In this study, we look at those costs by cause of death for aged Medicare beneficiaries who died in 1979. We found that expenditures varied markedly by cause of death. Cancer was the most expensive leading cause of death, with per capita expenses of $8,021, compared with $4,012 for heart disease. Because of the greater number of deaths from heart disease, expenses for heart disease decedents accounted for 8.2% of the total Medicare budget in 1979 compared with 7.2% for cancer. These data provide a baseline with which to evaluate the effects of major changes in Medicare on care for the dying.