Table 2. Adjusted Odds Ratios for Use of Health Care Resources in Last 30 Days of Life.

Measure (n = 950 665)	aOR (95% CI)	P value a
In-hospital death
No ACP	1 [Reference]	NA
ACP >30 d before death	0.85 (0.84-0.87)	<.001
ACP ≤30 d before death	1.22 (1.19-1.26)	<.001
Hospital admission in last 30 d
No ACP	1 [Reference]	NA
ACP >30 d before death	0.84 (0.83-0.85)	<.001
ACP ≤30 d before death	5.28 (5.07-5.50)	<.001
ICU admission in last 30 d
No ACP	1 [Reference]	NA
ACP >30 d before death	0.87 (0.85-0.88)	<.001
ACP ≤30 d before death	1.57 (1.53-1.62)	<.001
ED visit in last 30 d
No ACP	1 [Reference]	NA
ACP >30 d before death	0.83 (0.82-0.84)	<.001
ACP ≤30 d before death	3.87 (3.72-4.02)	<.001
Late hospice referral
No ACP	1 [Reference]	NA
ACP >30 d before death	1.06 (1.03-1.08)	<.001
ACP ≤30 d before death	1.84 (1.78-1.90)	<.001

Abbreviations: ACP, advance care planning; aOR, adjusted odds ratio; ED, emergency department; ICU, intensive care unit; NA, not applicable.

^a Bonferroni corrected P = .008 for 6 pairwise comparisons. All models were adjusted for sex, age group, race and ethnicity, Charlson Comorbidity Index score, hospital referral region median Medicare spending level, and dual eligibility status.