Table 2.

Healthcare Utilization in the Last 30 Days of Life for Medicare Patients Who Died in 2017, by Advance Care Planning Status

	Total		No billed ACP		Had billed ACP
Outcomes	N	%	N	%	N	%	P value
Location of death
Not in hospital	186,346	78.3	174,351	78.2	11,995	80.0	<.001
In hospital	51,643	21.7	48,652	21.8	2,991	20.0
Total	237,989	100.0	223,003	100.0	14,986	100.0
Admission in the last 30 d
No	123,761	52.0	115,894	52.0	7,867	52.5	.212
Yes	114,228	48.0	107,109	48.0	7,119	47.5
Total	237,989	100.0	223,003	100.0	14,986	100.0
ICU visit in last 30 d
No	193,897	81.5	181,463	81.4	12,434	83.0	<.0001
Yes	44,092	18.5	41,540	18.6	2,552	17.0
Total	237,989	100.0	223,003	100.0	14,986	100.0
Timely hospice care
≥4 d before death	197,667	83.1	185,337	83.1	12,330	82.3	.0085
<4 d before death	40,322	16.9	37,666	16.9	2,656	17.7
Total	237,989	100.0	223,003	100.0	14,986	100.0
EOL healthcare expenditures a
Mean, SD	$15,310.92 ($21,059.78)		$200,890	$15,233.87 ($21,116.92)	$14,131	16,406.32 ($20,198.97)	<.001
ED visit in last 30 d
No	112,351	47.2	105,080	47.1	7,271	48.5	.0009
Yes	125,638	52.8	117,923	52.9	7,715	51.5
Total	237,989	100.0	223,003	100.0	14,986	100.0

Abbreviations: ACP, advance care planning; ED, emergency department; EOL, end of life; ICU, intensive care unit; SD, standard deviation.

^aEOL expenditures in the last month of life from all settings including ambulatory, inpatient, skilled nursing, and hospice settings but not Part D drug expenditures.