How U.S. Doctors Die: A Cohort Study of Healthcare Use at the End of Life

Abstract

Objectives: To compare healthcare use in the last months of life between physicians and nonphysicians in the United States. Design: A retrospective observational cohort study. Setting: United States. Participants: Fee-for-service Medicare beneficiaries: decedent physicians (n = 9,947) and a random sample of Medicare decedents (n = 192,006). Measurements: Medicare Part A claims data from 2008 to 2010 were used to measure days in the hospital and proportion using hospice in the last 6 months of life as primary outcome measures adjusted for sociodemographic characteristics and regional variations in health care. Results: Inpatient hospital use in the last 6 months of life was no different between physicians and nonphysicians, although more physicians used hospice and for longer (using the hospital: odds ratio (OR) = 0.98, 95% confidence interval (CI) = 0.93–1.04; hospital days: mean difference 0.26, P =.14); dying in the hospital: OR = 0.99, 95% CI = 0.95–1.04; intensive care unit (ICU) or critical care unit (CCU) days: mean difference 0.35 more days for physicians, P