JNCI cancer spectrum · 2026
Association between palliative care consultation and care transition outcomes among hospitalized advanced cancer patients.
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Kim Hak Jun, Sim Jin-Ah, Lee Sun Young, Yoo Shin Hye
Аннотация
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 830 matched individuals, 30-day ED visits (45.8% vs 45.5%; adjusted odds ratio [aOR] = 0.95; 95% 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. Intensive care unit 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.
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 830 matched individuals, 30-day ED visits (45.8% vs 45.5%; adjusted odds ratio [aOR] = 0.95; 95% 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. Intensive care unit 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.