Table 1.

Characteristics of Medicare Beneficiaries Hospitalized in 2005–2009, Overall and by Tertile of Local Hospice Utilization^c*

Characteristic	Overalla,b(N=1,997,506)	Higha,b(N=665,176)	Mediuma,b(N=664,445)	Lowa,b(N=667,885)
Local hospice utilization, % (SD)	40 (12)	53 (5.9)	41 (3.1)	27 (6.5)
30-day patient outcomes
Rehospitalization	18.2	17.5	18.1	19.1
Mortality	6.0	6.3	6.0	5.8
Hospice enrollment	4.3	5.6	4.3	2.9
Patient sociodemographic characteristics
Age, mean (SD)	79 (7.8)	79 (7.8)	79 (7.8)	79 (7.8)
65–69 years	14	14	15	14
70–74 years	19	19	19	18
75–79 years	21	21	21	21
80–84 years	21	21	21	21
≥85 years	25	25	24	25
Gender
Male	37	37	37	37
Female	63	63	63	63
Race
White	87	91	86	83
Black	9.3	6.4	10	11
Other	4.0	2.9	3.5	5.6
Medicaid enrollment	19	15	19	24
Percentage of adults age ≥25 with at least a high school diploma in patient's census block groupd	81 (13)	83 (12)	81 (13)	79 (14)
Percentage below poverty level in patient's census block groupd	8.1 (9.5)	6.8 (8.0)	8.0 (9.4)	9.4 (11)
Patient medical history
Community HCC score prior to hospitalization, mean (SD)	2.5 (1.9)	2.5 (1.8)	2.5 (1.9)	2.6 (1.9)
1st quartile (mean=0.75)	25	26	25	24
2nd quartile (mean=1.56)	25	25	25	25
3rd quartile (mean=2.67)	25	25	25	25
4th quartile (mean=5.15)	25	24	25	26
Elixhauser comorbidities
Hypertension	56	58	56	56
Fluid and electrolyte disorders	33	35	33	32
Chronic pulmonary disease	28	29	28	28
Congestive heart failure	28	27	28	28
Deficiency anemias	25	25	25	25
Any othere	20	20	20	19
Diabetes without complications	15	15	15	15
Valvular disease	15	16	15	14
Hypothyroidism	15	16	15	14
Renal failure	14	15	14	14
Peripheral vascular disease	14	14	14	13
Other neurological disorders	12	12	12	12
Depression	12	12	12	11
Diabetes with complications	8.9	8.7	8.8	9.2
Obesity	6.5	7.0	6.6	6.1
Pulmonary circulation disease	6.2	6.8	6.2	5.5
Weight loss	6.1	6.5	6.4	5.5
Solid tumor without metastasis	6.0	6.1	6.1	5.7
Coagulopathy	5.5	5.9	5.5	5.0
Metastatic cancer	3.4	3.4	3.5	3.5
Number of hospitalizations in previous 12 months, mean (SD)	1.1 (1.6)	1.1 (1.6)	1.1 (1.6)	1.2 (1.7)
0	48	49	48	47
1	25	25	25	25
2	13	12	13	13
≥3	14	13	14	15
Duration of index hospitalization (days), mean (SD)	5.2 (5.3)	5.0 (4.8)	5.2 (5.2)	5.5 (5.8)
0–2 days	28	28	28	27
3–4 days	31	32	31	30
5–6 days	17	17	17	17
≥7 days	24	23	24	26
Nursing home stay within 30 days prior to index hospitalization	10	9.4	10	11
Presence of a disability	2.3	2.5	2.4	2.0
Index hospital characteristics
Average annual total discharge count, mean (SD)	7716 (5280)	8052 (5823)	7916 (5073)	7181 (4855)
>10,000 annual discharges	25	26	27	21
7001–10,000 annual discharges	20	22	21	18
4001–7000 annual discharges	31	30	29	33
≤4000 annual discharges	24	22	22	28
Medical school affiliation
None	52	60	49	47
Minor	24	21	27	24
Major	24	20	24	29
RUCA
Urban core area	87	91	89	80
Suburban area	1.7	2.2	1.4	1.4
Large town area	10	5.5	9.0	16
Small town and isolated rural area	1.5	1.1	1.1	2.0
Critical access hospital	0.5	0.4	0.4	0.5

HCC, Hierarchical Condition Categories; RUCA, Rural/Urban Commuting Area Code; SD, standard deviation.

^aAll values are percentages unless specified.

^bPercentages may not sum to 100 due to rounding.

^*All p-values are<0.001 except neurological disorders (0.90) and metastatic cancer (0.003).

^cLocal hospice utilization is defined as the percentage of patients that died who had entered into hospice care within each Hospice Service Area. See text for details.

^dCensus block group from the 2000 U.S. Census.

^eIncludes alcohol abuse, chronic blood loss anemia, drug abuse, liver disease, lymphoma, paralysis, peptic ulcer disease with bleeding, psychoses, rheumatoid arthritis/collagen vascular disease.