Three articles published Online First this week in theArchives of Internal Medicineexamine health care at the end of life. Two articles report on health care use and costs of care for older patients with heart failure in the last 6 months of life. One study was performed in theUnited Statesand the other inCanada, two countries that have markedly different health care systems. The third article examines the use of hospice in men with prostate cancer in theUnited States.
Unroe et al examine health care use and costs for US Medicare beneficiaries with heart failure in the last 6 months of life who died between 2000 and 2007. In a companion article, Kaul et al analyze resource use in the last 6 months of life among patients with heart failure inAlberta,Canada, who died between 2000 and 2006. Both studies report that use of health care services and the cost of care spiraled upward.