ArticleBMJ open2021
Hospital-based acute care in the last 30 days of life among patients with chronic disease that received early, late or no specialist palliative care: a retrospective cohort study of eight chronic disease groups.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines 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
- Impact of Specialty and Nonspecialty Palliative Care on Quality of Dying With Alzheimer's Disease or Related Dementias: A Systematic Review and Meta-Analysis.Medical care · 2025Pooled it
- Association of Palliative Care Initiation With Acute Healthcare Utilization Among Community-Dwelling Adults Living With Dementia.Journal of the American Geriatrics Society · 2026Article
- Article
- Reasons for unplanned hospitalisation in specialist community palliative care: a scoping review.BMC palliative care · 2025Article
- Integrating Neurology, Palliative Care and Emergency Services in ALS: A Community-Integrated Neuropalliative Pathway in Modena, Italy.Brain sciences · 2025Article
- Palliative care pathways in Amyotrophic Lateral Sclerosis (ALS): a sequence analysis of health claims data.BMC palliative care · 2025Article
- Developing theCurrent oncology (Toronto, Ont.) · 2025Article
- Understanding Experiences of Telehealth in Palliative Care: Photo Interview Study.JMIR human factors · 2025Article
- Utilization and quality of palliative care in patients with hematological and solid cancers: a population-based study.Journal of cancer research and clinical oncology · 2024Article
- Acceptability of automatic referrals to supportive and palliative care by patients living with advanced lung cancer: qualitative interviews and a co-design process.Research involvement and engagement · 2024Article
- Article
- 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
- Patient & Caregiver Experiences: Qualitative Study Comparison Before and After Implementation of Early Palliative Care for Advanced Colorectal Cancer.The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmieres · 2023Article
- Association between Consultation by a Comprehensive Integrated Palliative Care Program and Quality of End-of-Life Care in Patients with Advanced Cancer in Edmonton, Canada.Current oncology (Toronto, Ont.) · 2023Article
- Health Care Utilization in the Last Year of Life in Parkinson Disease and Other Neurodegenerative Movement Disorders.Neurology. Clinical practice · 2022Article
- A prospective cohort study assessing aggressive interventions at the end-of-life among patients with solid metastatic cancer.BMC palliative care · 2022Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveFor eight chronic diseases, evaluate the association of specialist palliative care (PC) exposure and timing with hospital-based acute care in the last 30 days of life.
designRetrospective cohort study using administrative data.
settingAlberta, Canada between 2007 and 2016.
participants47 169 adults deceased from: (1) cancer, (2) heart disease, (3) dementia, (4) stroke, (5) chronic lower respiratory disease (chronic obstructive pulmonary disease (COPD)), (6) liver disease, (7) neurodegenerative disease and (8) renovascular disease.
main outcome measuresThe proportion of decedents who experienced high hospital-based acute care in the last 30 days of life, indicated by ≥two emergency department (ED) visit, ≥two hospital admissions,≥14 days of hospitalisation, any intensive care unit (ICU) admission, or death in hospital. Relative risk (RR) and risk difference (RD) of hospital-based acute care given early specialist PC exposure (≥90 days before death), adjusted for patient characteristics.
resultsIn an analysis of all decedents, early specialist PC exposure was associated with a 32% reduction in risk of any hospital-based acute care as compared with those with no PC exposure (RR 0.69, 95% CI 0.66 to 0.71; RD 0.16, 95% CI 0.15 to 0.17). The association was strongest in cancer-specific analyses (RR 0.53, 95% CI 0.50 to 0.55; RD 0.31, 95% CI 0.29 to 0.33) and renal disease-specific analyses (RR 0.60, 95% CI 0.43 to 0.84; RD 0.22, 95% CI 0.11 to 0.34), but a~25% risk reduction was observed for each of heart disease, COPD, neurodegenerative diseases and stroke. Early specialist PC exposure was associated with reducing risk of four out of five individual indicators of high hospital-based acute care in the last 30 days of life, including ≥two ED visit,≥two hospital admission, any ICU admission and death in hospital.
conclusionsEarly specialist PC exposure reduced the risk of hospital-based acute care in the last 30 days of life for all chronic disease groups except dementia.
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