End-of-life care patterns associated with hospital-based palliative care consultation: a single-center cohort with national data linkage
7 affiliations
- 1The Graduate School of Public Health and Healthcare Management, The Catholic University of Korea, Seoul, South Korea
- 2Department of Population and Quantitative Health Science, UMass Chan Medical School, Worcester, MA USA
- 3Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
- 4Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080 South Korea
- 5Public Healthcare Center, Seoul National University Hospital, Seoul, South Korea
- 6Department of Human Systems Medicine, Seoul National University College of Medicine, Seoul, South Korea
- 7Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
Abstract
Background: In routine oncology practice, palliative care (PC) is commonly delivered through hospital-based consultation services integrated within existing workflows. Evidence describing real-world end-of-life (EOL) care patterns associated with consultation-based palliative care remains limited. We examined EOL care patterns associated with hospital-based palliative care consultation using linked clinical and nationwide data.
Patients and methods: This retrospective cohort study used linked data from a tertiary hospital and the Korean National Health Insurance Service. We included 18,048 decedents with advanced lung, stomach, colorectal, liver, or pancreaticobiliary cancer between 2018 and 2022. To minimize selection bias, 1:2 propensity score matching was performed. Outcomes included advance care planning documentation completion, aggressive EOL interventions, hospice utilization, and medical costs.
Results: After matching 4,102 patients with PC consultation and 7,910 controls, the consultation group showed significantly higher completion of advance statements (58.0% vs. 32.1%) and more patient-led decisions. During the final month of life, the consultation group had significantly fewer intensive care unit admissions (4.9% vs. 10.3%), emergency department visits (48.6% vs. 54.4%), and cardiopulmonary resuscitations (2.9% vs. 10.7%) (all P < 0.001). Hospice utilization was substantially higher in the consultation group (73.2% vs. 19.5%). Furthermore, PC consultations were associated with significantly lower medical costs during the final month and last two weeks of life.
Conclusion: Hospital-based palliative care consultation was associated with higher rates of advance care planning and hospice use, lower use of high-intensity EOL interventions, and modestly lower medical costs. These findings suggest that consultation-based palliative care within routine oncology workflows may meaningfully influence EOL care delivery.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12904-026-02215-9.
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BibTeX
@article{sim2026endoflife,
title = {{End-of-life care patterns associated with hospital-based palliative care consultation: a single-center cohort with national data linkage}},
author = {Jin-ah Sim and Jiwon Yu and Wantaek Lee and Ye Sul Jeung and Da-seul Park and Sun Young Lee and Bhumsuk Keam and Shin Hye Yoo},
journal = {BMC Palliative Care},
year = {2026},
month = aug,
doi = {10.1186/s12904-026-02215-9},
url = {https://doi.org/10.1186/s12904-026-02215-9},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - End-of-life care patterns associated with hospital-based palliative care consultation: a single-center cohort with national data linkage
AU - Jin-ah Sim
AU - Jiwon Yu
AU - Wantaek Lee
AU - Ye Sul Jeung
AU - Da-seul Park
AU - Sun Young Lee
AU - Bhumsuk Keam
AU - Shin Hye Yoo
PY - 2026
DA - 2026/08/10
JO - BMC Palliative Care
DO - 10.1186/s12904-026-02215-9
UR - https://doi.org/10.1186/s12904-026-02215-9
AB - Background: In routine oncology practice, palliative care (PC) is commonly delivered through hospital-based consultation services integrated within existing workflows. Evidence describing real-world end-of-life (EOL) care patterns associated with consultation-based palliative care remains limited. We examined EOL care patterns associated with hospital-based palliative care consultation using linked clinical and nationwide data. Patients and methods: This retrospective cohort study used linked data from a tertiary hospital and the Korean National Health Insurance Service. We included 18,048 decedents with advanced lung, stomach, colorectal, liver, or pancreaticobiliary cancer between 2018 and 2022. To minimize selection bias, 1:2 propensity score matching was performed. Outcomes included advance care planning documentation completion, aggressive EOL interventions, hospice utilization, and medical costs. Results: After matching 4,102 patients with PC consultation and 7,910 controls, the consultation group showed significantly higher completion of advance statements (58.0% vs. 32.1%) and more patient-led decisions. During the final month of life, the consultation group had significantly fewer intensive care unit admissions (4.9% vs. 10.3%), emergency department visits (48.6% vs. 54.4%), and cardiopulmonary resuscitations (2.9% vs. 10.7%) (all P < 0.001). Hospice utilization was substantially higher in the consultation group (73.2% vs. 19.5%). Furthermore, PC consultations were associated with significantly lower medical costs during the final month and last two weeks of life. Conclusion: Hospital-based palliative care consultation was associated with higher rates of advance care planning and hospice use, lower use of high-intensity EOL interventions, and modestly lower medical costs. These findings suggest that consultation-based palliative care within routine oncology workflows may meaningfully influence EOL care delivery. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12904-026-02215-9.
SN - 1472-684X
ER -