reports

Healthcare expenditure in the last year of life: the experience of South African medical schemes

Cape Town, South Africa: Actuarial Society of South Africa.

School of Management Studies, University of Cape Town, Rondebosch, South Africa

The aim of this paper is to investigate the costs incurred by medical schemes arising from the provision of benefits during the 12 months preceding a beneficiary’s death. There are two main areas of investigation. First, costs in the last year of life are compared to costs in earlier years prior to death. Second, decedent and survivor costs are compared. The relationship between last-year-of-life costs and age is analysed. Healthcare costs in the last year of life were found to 3.51 times higher than in the second last year of life. In addition, during the four-year study period per-beneficiary decedent costs were found to be between 15.26 and 25.31 times higher than survivor costs. The proportion of decedent claims relating to the provision of Prescribed Minimum Benefits increased over to the period to 80.10% in 2011.