Factors Associated With Hospital Admission in the Last Month: A Retrospective Single Center Analysis

Area of Science:

• Gerontology
• Palliative Care
• Health Services Research

Background:

• Health systems are increasingly focused on identifying risk factors for hospitalization in the last month of life to improve care quality and patient experience.
• Understanding these factors is crucial for enhancing end-of-life care and patient outcomes.

Purpose of the Study:

• To evaluate patient-specific factors associated with hospital admission within the final 30 days of life.
• Identifying key patient characteristics that predict last-month hospitalization.

Main Methods:

• Retrospective cohort analysis of 8488 patients with a primary care visit in the last year of life.
• Linked electronic health record and decedent data were used to examine healthcare utilization and end-of-life outcomes.
• Multivariable logistic regression identified patient factors associated with last-month hospital admission.

Main Results:

• 25.9% of patients experienced hospital admission in their last month of life.
• Metastatic cancer, liver disease, and heart failure were associated with the highest odds of last-month hospital admission (adjusted ORs ranging from 2.17 to 2.36).
• Among patients who died in a health system facility, 86.0% were admitted to the hospital in the last month.

Conclusions:

• Patients with metastatic cancer, liver disease, or heart failure have significantly higher odds of hospital admission in the last month of life.
• Collaborative interventions involving primary, palliative, and specialty care are recommended to improve end-of-life care quality for high-risk patients.