Social Science and Medicine, vol. 55, 2002, p.593-608
Hospital discharge data from Germany's largest health insurer show that the cost of caring for patients during the last year of life makes up a large part of total health care expenditure. The costs of treatment during the last year of life are reduced if people die at an advanced age. Multivariate analysis reveals that the oldest patients receive less costly treatment than younger patients for the same illnesses and that this pattern is more pronounced for elderly women than for elderly men. These findings indicate that care in Germany is informally rationed according to the age and sex of the patient.