e24068 Background: Regardless of detailed advantages of palliative care for cancer patients, there is limited research about the utilization of palliative care services for women with metastatic breast cancer, particularly at the end-of-life. The purpose of this study was to determine the incidence of inpatient palliative care consultations (PCC) in women with metastatic breast cancer and to examine the association between palliative care consultation and hospital length of stay (LOS) and in-hospital costs in a nationally representative sample. Methods: Women, 18 years and older, with a metastatic breast cancer related hospitalization in the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Database (NIS) 1998-2017 were included in the study. Multivariable logistic and linear regression analyses were used to examine the effects of patient and hospital characteristics on the receipt inpatient palliative care, length of stay and total hospital charges. SAS software survey procedures (version 9.4, SAS Institute Inc, Cary, NC) were used for all analyses to account for the sampling design of NIS. Results: Older women were associated with higher odds of getting PCC [aOR, 95% CI (60-69 yrs: 1.08 (1.01, 1.16); ≥70 yrs: 1.25 (1.17, 1.34))]. Women of races other than White [Blacks: 1.12 (1.07, 1.16); Other races 1.08 (1.04, 1.13)], and patients from Zip codes of with lower household income levels were more likely to receive a palliative care consult [0-25^th percentile: 1.17 (1.12, 1.21); 26-50^th percentile 1.05 (1.01, 1.09); 51-75^th percentile 1.06 (1.02, 1.20)]. Women receiving governmental insurance had slightly lower odds of receiving palliative care compared to women receiving commercial types of insurance [0.94 (0.91, 0.98)]. Small and medium-sized hospitals were less likely to offer the service to admitted women [0.87 (0.84, 0.91)]. Hospitals located in the Northeast, Midwest, South were associated with lower odds of offering inpatient PCC when compared to hospitals in the West. A woman with any comorbidity had higher odds of receiving a PCC during their hospital admission. Hospitals were likely to charge patients receiving palliative care services less compared to patients who did not have a PCC encounter (Estimate: -5450; 95% CI: -5968, -4936) despite being associated with higher odds of a longer hospital stay (> 4 days) [1.17 (1.14, 1.20)]. Conclusions: Our study found that inpatient PCC for women with metastatic breast cancer increased LOS and hospital costs. We also found that inpatient palliative care consultation was provided to sicker patients; patients who would likely have longer length of stay, and in return, higher hospital costs compared to those without multiple acute comorbidities. Hence, targeted interventions must be implemented to increase PCC for metastatic breast cancer patients in the United States.