Background: Medicare beneficiaries incur 27%-30% of lifetime charges in the last year of life; most charges occur in the last quarter. Factors associated with high end-of-life Medicare charges include less advanced age, non-white race, absence of advance directive, and urban residence. Methods: We analyzed Medicare hospital charges in the last…

Context: Research has demonstrated substantial differences between end-of-life care in rural and urban settings. As the end of life approaches, rural elders are less likely to be hospitalized, to be placed in an intensive care unit, or to have a feeding tube, compared to their urban counterparts. These differences cannot be fully explained by…