RISK INDICATORS FOR HOSPITALIZATION DURING THE LAST YEAR OF LIFE

Objective. High levels of hospital expenditures for older people durin g their last year of life are widely documented. However, evidence of the association between prospectively measured indicators and subseque nt hospitalization is sparse. This article investigates the pattern of hospitalization for a sample of Medicare enrollees during their last year of life. Data Sources. Data from the Longitudinal Study of Aging, a national study of persons age 70 and older, are used. Only data on d ecedents are used. Study Design. We determine individual characteristi cs (including functional status, evidence of disease, living arrangeme nt, and prior hospitalization) shortly before the last year of life. A distinction is made between terminal and nonterminal admissions. Nati onal estimates and regression analyses using survey weights are conduc ted. Principal Findings. The likelihood of any use is high regardless of age, functional status, or the presence of major diseases. Although only a few indicators are associated with having a terminal stay, a n umber of indicators are associated with nonterminal use. Nonterminal s tays and total nights hospitalized are positively associated with prio r evidence of disease, prior hospitalization, and age, although the pr obability of nonterminal use decreases with age for persons over 82 ye ars old. The relationship between use and functional status depends on whether persons lived alone, were institutionalized, or had private h ealth insurance. Conclusions. This study demonstrates that while it is difficult to predict who will be admitted to the hospital at the time of death, a number of characteristics existing before the last year o f life are associated with nonterminal hospitalization and total night s hospitalized during the last year of life.