Table 3.

Association between Advance Care Planning and Quality End-of-life Care

Metrics	Adjusted RR (95% CI)		P Value
Hospital admission	AD only vs. no-ACP	0.92 (0.78-1.09)	0.33
	DPOA only vs. no-ACP	0.98 (0.86-1.12)	0.82
	Discussion only vs. no-ACP	1.05 (0.96-1.15)	0.26
In-hospital death	AD only vs. no-ACP	0.86 (0.73-1.01)	0.07
	DPOA only vs. no-ACP	0.88 (0.78-1.00)	0.05
	Discussion only vs. no-ACP	1.02 (0.92-1.14)	0.64
> 14 days in hospital	AD only vs. no-ACP	0.31 (0.13-0.73)	0.008
	DPOA only vs. no-ACP	0.96 (0.67-1.39)	0.84
	Discussion only vs. no-ACP	0.97 (0.77-1.22)	0.77
ICU admission	AD only vs. no-ACP	0.81 (0.55-1.18)	0.26
	DPOA only vs. no-ACP	0.90 (0.72-1.14)	0.38
	Discussion only vs. no-ACP	1.02 (0.90-1.17)	0.72
> 1 ED visits	AD only vs. no-ACP	1.04 (0.65-1.66)	0.87
	DPOA only vs. no-ACP	0.97 (0.71-1.34)	0.87
	Discussion only vs. no-ACP	0.89 (0.70-1.13)	0.33
Hospice admission	AD only vs. no-ACP	1.67 (1.20-2.33)	0.003
	DPOA only vs. no-ACP	1.40 (1.12-1.76)	0.004
	Discussion only vs. no-ACP	1.48 (1.24-1.76)	<0.001
Length of hospice stay ≤ 3 days	AD only vs. no-ACP	0.88 (0.78-0.99)	0.03
	DPOA only vs. no-ACP	0.93 (0.88-0.99)	0.02
	Discussion only vs. no-ACP	0.92 (0.87-0.96)	0.001

RR = relative risk, AD = advance directive, ACP = advance care planning, DPOA = durable power of attorney, ICU = intensive care unit, ED = emergency department

Relative Risk was estimated by Poisson regression with point and variance estimates by using jackknife replication method.

Reported values incorporate survey weights to account for the complex survey design.

Covariates include demographic characteristics (age at death, gender, race/ethnicity, married/partnered status, net worth, year of death) and medical comorbidities (cancer, hypertension, diabetes, lung diseases, heart diseases, stroke, and cognitive impairment).