Burden of hospital admissions and utilization of hospice care in @entity263 XXXX .

@entity1 @entity24818 @entity263
OBJECTIVE: To examine the rates of hospitalization in @entity1 with @entity263 ( @entity24818 ), as well as the effect of hospice utilization on the cost patterns of @entity24818 . Over the past decade, dramatic changes in the management of advanced @entity263 have proceeded alongside changes in end-of-life care. But, the impact of these contemporary advances in management of @entity24818 and its implications on US health care expenditure remains unknown. METHODS: @entity1 hospitalized with @entity24818 from 1998 to 2010 were extracted from the Nationwide Inpatient Sample (n  = 100,220). Temporal trends in incidence and charges were assessed by linear regression. Complex samples logistic regression models were used to identify the predictors of in-hospital mortality, elevated hospital charges beyond the 75th percentile and hospice utilization. RESULTS: Between 1998 and 2010, admissions for @entity24818 decreased at a rate of  -5.95% per year (P  <.001), whereas per-incident charges increased at the rate of 6.1% (P  <.001) annually; the national economic burden of care was stable. Over the study period, hospice use increased 488.0% per year (P  <.001) but was significantly lower among black (odds ratio [OR], 0.73; P  = .01) and Hispanic (OR, 0.65; P  = .03) @entity1 . In multivariable analyses, hospice utilization was associated with decreased odds of elevated hospital charges beyond the 75th percentile (OR, 0.84; P  = .02). CONCLUSION: Despite a decline in hospitalizations for @entity24818 , the economic burden of care has remained stable. Increasing use of hospice services has moderated the effect of rising per-incident hospital charges, highlighting the importance of promoting access to hospice in the right clinical setting. These findings have important policy implications, particularly as advances in treatment are expected to further increase expenditures related to the inpatient management of @entity24818 .
