Association between palliative care consultation and care transition outcomes among hospitalized advanced cancer patients
Menée en Corée à partir de données portant sur 830 patients hospitalisés pour un cancer de stade avancé, cette étude analyse l'effet d'une consultation hospitalière de soins palliatifs sur la survie et sur l'utilisation, 30 jours après la sortie, des services de santé (visites aux services d'urgence, ré-admissions hospitalières, admissions dans des services de soins intensifs)
Background: The period after hospital discharge is a high-risk phase for patients with advanced cancer, often involving acute-care use that reflects transitional care quality. The impact of inpatient palliative care (PC) consultation on short-term post-discharge outcomes, however, remains uncertain. We assessed whether inpatient PC consultation was associated with differences in 30-day post-discharge outcomes.
Methods: Using electronic medical records from a tertiary hospital linked with national claims data, we identified patients with lung, stomach, colorectal, liver, or pancreatobiliary cancer who died between 2018 and 2023. Those discharged alive after a hospitalization with inpatient PC consultation were matched 1:1 to patients without PC using propensity scores. Outcomes were 30-day emergency department (ED) visits, hospital readmissions, and intensive care unit (ICU) admissions, 30-day mortality and total direct medical costs. Fine–Gray competing risk and generalized linear models were used for comparisons.
Results: Among matched 830 individuals, Thirty-day ED visits (45.8% vs 45.5%; adjusted odds ratio [aOR], 0.95; 95% confidence interval [CI], 0.72 to 1.27) and readmission rates (69.6% vs 72.3%; aOR, 0.86; 95% CI, 0.63 to 1.18) were similar. ICU admission rates were substantially lower among patients receiving PC (1.9% vs 9.2%; aOR, 0.17; 95% CI, 0.07 to 0.37). The total 30-day medical costs were lower in the PC group (cost ratio, 0.65; 95% CI, 0.55 to 0.76). Thirty-day mortality was higher among patients who required PC (37.6% vs 16.1%).
Conclusion: Inpatient PC consultation was not associated with 30-day ED visits or hospital readmissions, but was linked to substantially lower ICU admissions and reduced short-term medical costs.
JNCI Cancer Spectrum , article en libre accès, 2026