Place of death is one indicator of the state of end-of-life care. We examine trends in national death certificate data on place of death from 1980 to 1998. During these years the percentage of Americans dying as hospital inpatients decreased from approximately 54 percent to 41 percent. About 310,000 fewer people died in the hospital in 1998 than if the proportion of inpatient deaths had not changed since 1980. For certain diseases the change was much greater. In 1980 whites and African Americans died in the hospital in equal proportions, but in 1998 whites died as inpatients less often than African Americans. These racial differences and their implications deserve further study.