Age and Gender Differences in Health Care Utilization and Spending for Medicare Beneficiaries in Their Last Years of Life

Men's and women's health care experiences differ as they age. While increasing attention has been focused on gender differences in health status, prevalence of illnesses, and access to quality care among older adults, little is known about differences in their health care in the last years of their lives. This paper uses claims data for a 0.1% random sample of Medicare beneficiaries who died between January 1, 1994 and December 31,1998 to assess age and gender differences among Medicare-eligible adults in their utilization of health care services in the last year of life. Overall, age is much more important than gender in explaining most of the variation in end-of-life care. The combination of being a Medicare beneficiary and being sick enough to die appears to attenuate gender disparities in health care services utilization.