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a RAND Corporation, Arlington, VA
b Harvard Medical School, Boston, MA
Correspondence: Melinda Beeuwkes Buntin, PhD, RAND Corporation, 1200 S. Hayes Street, Arlington, VA 22202-5050. E-mail: buntin{at}rand.org.
Purpose: This article reviews the state of science on the economics of end-of-life care for Medicare beneficiaries and outlines the research needed to fill gaps in that literature. Design and Methods: Searches of the medical, health services, and economics literature were conducted. Key topics examined were studies of spending on end-of-life care and financial, organizational, and nonfinancial barriers to high-quality end-of-life care. Results:Studies have documented poor quality of care, dissatisfaction with care, and limitations in the coverage of end-of-life care for Medicare beneficiaries. However, critical gaps in our knowledge about how to design a better end-of-life care system for Medicare beneficiaries remain. Implications: Further research on how treatment decisions at the end of life are made and prospective studies of costs, satisfaction, and outcomes are needed.
Key Words: Financing • Payment systems • Terminal illness • End-of-life care
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