%0 Journal Article %T End %A Alexandra L. Hanlon %A Connie Ulrich %A Elizabeth Mauer %A Karen B. Hirschman %A Ken Coburn %A Mary Naylor %A Meredith MacKenzie Greenle %A Sherry Marcantonio %J American Journal of Hospice and Palliative Medicine£¿ %@ 1938-2715 %D 2019 %R 10.1177/1049909118824962 %X Patients with chronic illness are associated with high health-care utilization and this is exacerbated in the end of life, when health-care utilization and costs are highest. Complex Care Management (CCM) is a model of care developed to reduce health-care utilization, while improving patient outcomes. We aimed to examine the relationship between health-care utilization patterns and patient characteristics over time in a sample of older adults enrolled in CCM over the last 2 years of life. Generalized estimating equation models were used. The sample (n = 126) was 52% female with an average age of 85 years. Health-care utilization rose sharply in the last 3 months of life with at least one hospitalization for 67% of participants and an emergency department visit for 23% of participants. In the last 6 months of life, there was an average of 2.17 care transitions per participant. The odds of hospitalization increased by 27% with each time interval (P < .001). Participants demonstrated 11% greater odds of having a hospitalization for each additional comorbidity (P = .05). A primary diagnosis of heart failure or coronary artery disease was associated with 21% greater odds of hospitalization over time compared to other primary diagnoses (P = .017). Females had 70% greater odds of an emergency department visit compared to males (P = .046). For each additional year of life, the odds of an emergency department visit increased by about 7% (P < .001). Findings suggest the need for further interventions targeting chronically ill older adults nearing end of life within CCM models %K end of life %K chronic illness %K older adults %K outcomes %K health-care utilization %K quality of care %U https://journals.sagepub.com/doi/full/10.1177/1049909118824962