Table 3. Mean Difference in Expenditure Among HRR Groups.
| HRR group by ACP (n = 929 505) | Mean difference (95% CI), $ | P valuea |
|---|---|---|
| All | ||
| No ACP | 1 [Reference] | NA |
| ACP >30 d before death | 562 (408 to 716) | <.001 |
| ACP ≤30 d before death | 8616 (8337 to 8894) | <.001 |
| HRR median Medicare spending level low | ||
| No ACP | 1 [Reference] | NA |
| ACP >30 d before death | –281 (–695 to 132) | .18 |
| ACP ≤30 d before death | 7942 (7231 to 8652) | <.001 |
| HRR median Medicare spending level medium | ||
| No ACP | 1 [Reference] | NA |
| ACP >30 d before death | 245 (46 to 445) | .02 |
| ACP ≤30 d before death | 7931 (7573 to 8289) | <.001 |
| HRR median Medicare spending level high | ||
| No ACP | 1 [Reference] | NA |
| ACP >30 d before death | 1411 (1117 to 1704) | <.001 |
| ACP ≤30 d before death | 10 166 (9615 to 10 717) | <.001 |
Abbreviations: ACP, advance care planning; HRR, hospital referral region; NA, not applicable.
a
Bonferroni corrected P = .008 for 6 pairwise comparisons. All models adjusted for sex, age group, race and ethnicity, Charlson Comorbidity Index, HRR median Medicare spending level, and dual eligibility status.