“The High Cost of Dying”: What Do the Data Show?

Assertions that we now spend too much of our medical dollar on the dying often imply a ready target for cost-containment efforts: frequency and intensity of expenditures at the end of life, especially for the aged. But available, although meager data suggest there has been neither a dramatic rise in the last 20 years in the use of the hospital as a place to die, nor of widespread use of "heroic" interventions on behalf of those who die. Rather, very sick patients receive intensive and expensive care; our ability to project rates of survival vs. terminal patient status warrants caution in approaches to medical economy.