Appendix Table 1.

Sensitivity Analysis of Results without Multiple Imputation

	ACP (N = 230)		Match (N = 230)		Unadjusteda		Adjustedb
	Pre-12 months before ACP date A	Last 12 months before death B	Pre-12 months before match date C	Last 12 months before death D	Difference-in-difference (B-D)-(A-C)	P	Difference-in-difference (B-D)-(A-C)	P
Total expenditurec	$11,367	$29,542	$8,113	$36,720	−$10,433	0.011	−$10,781	0.010
95% CI					−18,467, −2,398		−18,942, −2,619
Utilizations
Inpatient admissions	0.44	1.36	0.27	1.51	−0.32	0.071	−0.41	0.021
95% CI					−0.67, 0.03		−0.76, −0.06
Inpatient days	2.69	9.44	1.86	11.55	−2.95	0.073	−3.57	0.028
95% CI					−6.18, 0.23		−6.75, −0.39
ICU days (inpatient)	0.00	2.17	0.01	2.20	−0.02	NA	−0.14	0.800
95% CI					NA		−1.25, 0.96
Hospice use	0.04	1.17	0.02	1.38	−0.23	0.345	−0.20	0.412
95% CI					−0.72, 0.25		−0.66, 0.27
Hospice days	0.88	23.78	0.52	31.10	−7.68	0.260	−7.01	0.288
95% CI					−21.05, 5.69		−19.94, 5.91
SNF use	0.14	0.80	0.24	1.00	−0.09	0.557	−0.13	0.416
95% CI					−0.40, 0.22		−0.44, 0.18
HHA use	0.32	0.54	0.18	0.54	−0.14	0.230	−0.17	0.130
95% CI					−0.36, 0.09		−0.39, 0.05
30-day readmissions	0.12	0.22	0.03	0.23	−0.11	0.113	−0.12	0.064
95% CI					−0.24, 0.02		−0.25, 0.01
ED visit	0.06	1.80	0.07	1.69	0.12	0.573	−0.029	0.877
95% CI					−0.29, 0.52		−0.39, 0.34

^aGeneralized linear model with gamma distribution (expenditure) or Poisson distribution (utilizations).

^bGeneralized linear model with gamma distribution (expenditure) or Poisson distribution (utilizations) adjusted by age, gender, race, CMS risk score, and comorbidities (CHF, COPD, ESRD, and cancer).

^cAll expenditures were converted to 2016 U.S. dollars using Medical Component of Consumer Price Index.

ACP, advance care planning; CHF, congestive heart failure; CMS, Center for Medicare and Medicaid Services; COPD, Chronic Obstructive Pulmonary Disease; ESRD, end-stage renal disease; SNF, skilled nursing facility; ED, emergency department.