Unexplained periods of higher deaths contribute to marginal changes in health care demand and health insurance costs: International perspectives.

Sudden and unexplained increases in hospital medical admissions and population total deaths have been characterized in the United Kingdom. These sudden increases appear to endure for around 1 to 3 years before they abate. This study demonstrates that the sudden increases in deaths also occur in 125 countries and occur at subnational geographies. The magnitude of the sudden increase diminishes as a power law function up to around 10 000 deaths. Above 10 000 deaths, there is only a small decline with increasing size (deaths). At around 10 000 deaths, a 10% maximum sudden increase applies across many countries or subnational regions. The nearness to death effect, where around half of a person's lifetime hospital admissions occurs in the last 6 months of life, results in higher associated increases in medical admissions. This paper confirms that the use of calendar year data can be misleading. Periods of unexplained higher deaths appear to occur in bursts across multiple countries and appear to show spatial spread within the neighbourhoods which constitute the whole country.