Trajectories of end-of-life medical and long-term care expenditures for older adults in Japan: retrospective longitudinal study using a large-scale linked database of medical and long-term care claims

We analyzed trajectories of medical and long-term care expenditures during the 60 months before the date of death. We identified six distinct spending trajectories for the total care expenditures. Factors associated with the high-persistent trajectory were chronic illnesses, various organ failures, neurodegenerative diseases, fractures, and tube feeding. This finding has implications for improving the quality of end-of-life care and its financial foundation.