Follow us
Publications Commentary Research People Events News Resources and Videos About IFS
Home Publications Variation in end-of-life hospital spending in England: Evidence from linked survey and administrative data

Variation in end-of-life hospital spending in England: Evidence from linked survey and administrative data

George Stoye and Tom Lee
IFS Working Paper W19/22

Much of lifetime healthcare spending is concentrated at the end of life. This paper uses survey data linked to administrative hospital and mortality records to examine how the pattern of end-of-life hospital inpatient spending varies across different groups within a large public hospital system in England. In line with existing studies we find that spending rises sharply at the end of life even after controlling for changes in health, but the pattern of these increases varies across household composition and socioeconomic status. Quarterly spending increases more sharply for those in couples at the end of life: a 10% reduction in time to death is associated with a 10% rise in individual spending among couples, but only 8% for singles. Spending is also lower in the last 18 months of life for those with no formal qualifications relative to their more educated peers due to lower use of elective care. Differences across groups are not explained by differences in observed morbidity or cause of death, but could be explained by differential access to, or preferences for, care. These results suggest that policymakers should consider broader trends in sociodemographic attributes when forecasting future health spending and in evaluating inequity in healthcare use.

More on this topic

This report examines the effect that variation in the cost of living has on the labour supply of existing nurses in NHS acute trusts. Retention of nursing staff within the NHS is a key policy issue. Pay policy – and the ability that trusts and nurses have to react to local working conditions and ...
Press release
Improving the retention of NHS staff has been a long-term policy challenge, and will be of even greater importance in the aftermath of the Covid-19 pandemic. A new report by researchers at the Institute for Fiscal Studies and Imperial College London, as part of the National Institute for Health ...
Newspaper article
Hancock is just the latest in a very long line to grasp for that illusion of control. One day, probably in a decade or so, one of his successors will be so burnt by the experience of attempting to achieve the impossible that another re-disorganisation will be visited upon a system still doing its ...