SynthesisThe American journal of hospice & palliative care2019
Associations Among End-of-Life Discussions, Health-Care Utilization, and Costs in Persons With Advanced Cancer: A Systematic Review.
Synthesis in The American journal of hospice & palliative care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
60 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Needs and health-related quality of life domains relevant to people in Europe with advanced cancer in need of palliative care: a systematic review of qualitative research.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Pooled it
- Relevance and consequence of economic and social resources of severely ill persons and their informal caregivers at the end-of-life: a systematic review of qualitative studies.BMC palliative care · 2025Pooled it
- Evaluating outcomes of advance care planning interventions for adults living with advanced illness and people close to them: A systematic meta-review.Palliative medicine · 2025Pooled it
- Question prompt list intervention for patients with advanced cancer: a systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Pooled it
- Why is advance care planning underused in oncology settings? A systematic overview of reviews to identify the benefits, barriers, enablers, and interventions to improve uptake.Frontiers in oncology · 2023Pooled it
- A systematic review defining non-beneficial and inappropriate end-of-life treatment in patients with non-cancer diagnoses: theoretical development for multi-stakeholder intervention design in acute care settings.BMC palliative care · 2022Pooled it
- Mindfulness to enhance quality of life and support advance care planning: a pilot randomized controlled trial for adults with advanced cancer and their family caregivers.BMC palliative care · 2024Trial
- Perceptions of prognosis and end-of-life care outcomes in patients with advanced lung and gastrointestinal cancer.Palliative medicine · 2023Trial
- Healthcare use and healthcare costs for patients with advanced cancer; the international ACTION cluster-randomised trial on advance care planning.Palliative medicine · 2023Trial
- Association between family-perceived quality of death and dying, prognostic awareness, and end-of-life discussions in five common diseases: a nationwide mortality follow-back study.BMC palliative care · 2026Article
- The impact of municipal healthcare setting on the quality of end-of-life care: a population-based cohort study.BMC palliative care · 2026Article
- Facilitators of and barriers to high-quality care at end-of-life: experiences of terminally ill patients and their relatives.BMC palliative care · 2026Article
- Timing of specialist palliative care and acute healthcare utilization at the end of life among adults who died of cancer: a nationwide cohort study.BMC cancer · 2026Article
- Healthcare utilization and end-of-life care based on life-sustaining treatment decisions in patients with cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Hospice care for Medicaid cancer patients in Puerto Rico: implications on healthcare costs and utilization.JNCI cancer spectrum · 2026Article
- Temporal trends and determinants of inpatient palliative care utilization among hospitalized patients with acute myeloid leukemia: a retrospective cross-sectional study.BMC palliative care · 2025Article
- Identifying clusters of healthcare expenditure trajectories in end-stage organ disease: a retrospective cohort study using linked administrative databases in Singapore.BMC health services research · 2025Article
- End-of-life in Hepatocellular Carcinoma: How Palliative Care and Social Factors Impact Care and Cost.Journal of clinical gastroenterology · 2025Article
- Casemanagers Positioned as Key Advance Care Planning Conversationalists in Oncology Care: A Qualitative Interview Study on the Perspectives of Healthcare Professionals and Patients.Cancer medicine · 2025Article
- Early and late code status documentation in cancer patients managed by a dedicated supportive care team.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
backgroundAggressive end-of-life (EOL) care is associated with lower quality of life and greater regret about treatment decisions. Higher EOL costs are also associated with lower quality EOL care. Advance care planning and goals-of-care conversations ("EOL discussions") may influence EOL health-care utilization and costs among persons with cancer.
objectiveTo describe associations among EOL discussions, health-care utilization and place of death, and costs in persons with advanced cancer and explore variation in study measures.
methodsA systematic review was conducted using PubMed, Embase, and CINAHL. Twenty quantitative studies published between January 2012 and January 2019 were included.
resultsEnd-of-life discussions are associated with lower health-care costs in the last 30 days of life (median US$1048 vs US$23482;
conclusionsEnd-of-life discussions are associated with less aggressive, less costly EOL care. Clinicians should initiate these discussions with patients having cancer earlier to better align care with preferences.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.