ArticlePloS one2017
The impact of community-based palliative care on acute hospital use in the last year of life is modified by time to death, age and underlying cause of death. A population-based retrospective cohort study.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Reasons for patients in high income countries accessing hospital care while receiving specialist community palliative care: A systematic review and meta-ethnography.Palliative medicine · 2026Pooled it
- Healthcare burden and impoverishment among older adults with palliative care needs in India: findings from a nationally representative study.BMC palliative care · 2026Article
- "Supportive relationships over support services"-A qualitative study of patient and caregiver perspectives on the implementation of community-based palliative care for people living with advanced noncommunicable diseases.Palliative care and social practice · 2026Article
- Reasons for unplanned hospitalisation in specialist community palliative care: a scoping review.BMC palliative care · 2025Article
- Changes in end-of-life care models among Chinese older adults, 1998-2018: an age-period-cohort analysis.BMC geriatrics · 2025Article
- Describing the characteristics and symptom profile of a group of urban patients experiencing socioeconomic inequity and receiving palliative care: a descriptive exploratory analysis.Palliative care and social practice · 2024Article
- Article
- A Comparison of the Survival, Place of Death, and Medical Utilization of Terminal Patients Receiving Hospital-Based and Community-Based Palliative Home Care: A Retrospective and Propensity Score Matching Cohort Study.International journal of environmental research and public health · 2021Article
- End-of-life outcomes with or without early palliative care: a propensity score matched, population-based cancer cohort study.BMJ open · 2021Article
- Hospitalisation at the end of life among cancer and non-cancer patients in Denmark: a nationwide register-based cohort study.BMJ open · 2020Article
- Article
- Palliative care needs of advanced cancer patients in the emergency department at the end of life: an observational cohort study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2020Observational
- A scoping review of initiatives to reduce inappropriate or non-beneficial hospital admissions and bed days in people nearing the end of their life: much innovation, but limited supporting evidence.BMC palliative care · 2020Article
- Early initiation of palliative care is associated with reduced late-life acute-hospital use: A population-based retrospective cohort study.Palliative medicine · 2019Article
- Palliative care as an emerging role for respiratory health professionals: Findings from a cross-sectional, exploratory Canadian survey.Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR · 2019Article
- Health service utilisation during the last year of life: a prospective, longitudinal study of the pathways of patients with chronic kidney disease stages 3-5.BMC palliative care · 2018Observational
- Article
- Community-based specialist palliative care is associated with reduced hospital costs for people with non-cancer conditions during the last year of life.BMC palliative care · 2017Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveCommunity-based palliative care is known to be associated with reduced acute care health service use. Our objective was to investigate how reduced acute care hospital use in the last year of life varied temporally and by patient factors.
methodsA retrospective cohort study of the last year of life of 12,763 Western Australians who died from cancer or one of seven non-cancer conditions. Outcome measures were rates of hospital admissions and mean length of hospital stays. Multivariate analyses involved time-to-event and population averaged log-link gamma models.
resultsThere were 28,939 acute care overnight hospital admissions recorded in the last year of life, an average of 2.3 (SD 2.2) per decedent and a mean length of stay of 9.2 (SD 10.3) days. Overall, the rate of hospital admissions was reduced 34% (95%CI 1-66) and the mean length of stay reduced 6% (95%CI 2-10) during periods of time decedents received community-based palliative care compared to periods of time not receiving this care. Decedents aged <70 years receiving community-based palliative care showed a reduced rate of hospital admission around five months before death, whereas for older decedents the reduction in hospital admissions was apparent a year before death. All decedents who were receiving community-based palliative care tended towards shorter hospital stays in the last month of life. Decedents with neoplasms had a mean length of stay three weeks prior to death while not receiving community-based palliative care of 9.6 (95%CI 9.3-9.9) days compared to 8.2 (95% CI 7.9-8.7) days when receiving community-based palliative care.
conclusionRates of hospital admission during periods of receiving community-based palliative care were reduced with benefits evident five months before death and even earlier for older decedents. The mean length of hospital stay was also reduced while receiving community-based palliative care, mostly in the last month of life.
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