@article {9553, title = {Impact of In-Hospital Death on Spending for Bereaved Spouses.}, journal = {Health Services Research}, volume = {53}, year = {2018}, pages = {2696-2717}, abstract = {

OBJECTIVE: To examine how patients{\textquoteright} location of death relates to health care utilization and spending for surviving spouses.

DATA SOURCES/STUDY SETTING: Health and Retirement Study (HRS) 2000-2012 linked to the Dartmouth Atlas and Medicare claims data.

STUDY DESIGN: This was an observational study. We matched bereaved spouses whose spouses died in a hospital to those whose spouses died outside the hospital using propensity scores based on decedent and spouse demographic and clinical characteristics, care preferences, and regional practice patterns.

DATA COLLECTION/EXTRACTION METHODS: We identified 1,348 HRS decedents with surviving spouses. We linked HRS data from each dyad with Medicare claims and regional characteristics.

PRINCIPAL FINDINGS: In multivariable models, bereaved spouses of decedents who died in the hospital had $3,106 higher Medicare spending 12~months postdeath (p~=~.04) compared to those whose spouses died outside a hospital. Those surviving spouses were also significantly more likely to have an ED visit (OR = 1.5; p~<~.01) and hospital admission (OR~= 1.4; p~=~.02) in the year after their spouse{\textquoteright}s in-hospital death. Increased Medicare spending for surviving spouses persisted through the 24-month period postdeath ($5,310; p~=~.02).

CONCLUSIONS: Bereaved spouses of decedents who died in the hospital had significantly greater Medicare spending and health care utilization themselves after their spouses{\textquoteright} death.

}, keywords = {Bereavement, End of life decisions, Medicare linkage, Medicare/Medicaid/Health Insurance}, issn = {1475-6773}, doi = {10.1111/1475-6773.12841}, author = {Katherine A. Ornstein and Melissa M. Garrido and Albert L. Siu and Bollens-Lund, Evan and Kenneth M. Langa and Amy S. Kelley} }