Costs for N.Y.'s Ill Elderly Among Highest in Nation

Medical spending on the chronically ill elderly in New York, New Jersey, and California exceeds the American average by more than 20%, and the patients in those states don't live any longer, a study found.

Medicare, the American health insurance program for the elderly, spends $81,143 in Manhattan in the last two years of a patient's life compared with $29,116 in Dubuque, Iowa, according to the study released yesterday by the Dartmouth Institute for Health Policy and Clinical Practice.

"Care varies dramatically from place to place without differences in outcomes," the co-author of the study and a professor of pediatrics at Dartmouth Medical School, David Goodman, said. "A sick patient in Iowa is the same as a sick patient in Manhattan. It's just that the end-of-life bill is higher."