Health care utilization in the years prior to death

The impact of an aging population on the health care system is a primary speculative concern for health policy. Unique data from a large sample of 4,263 decedents aged 45 years and over in Manitoba, Canada, describe actual utilization in the four years prior to death: all hospitalizations, nursing home stays, and ambulatory physician contacts. Total expenditures associated with dying do increase with age, but even among the very elderly many deaths have few expenditure consequences. Apocalyptic scenarios for the health care system may be premature.