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ED Visits Among Patients With Advanced Cancer Referred to Outpatient Palliative Care.
Ye Sul Jeung1, Sung A Bae2, Sun Young Lee3,4
1Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul, Republic of Korea.
JAMA Network Open
|July 15, 2025
Summary
Early outpatient palliative care referrals reduced end-of-life emergency department (ED) visits for advanced cancer patients. Timely integration of palliative care is crucial for improving end-of-life care and reducing hospitalizations.
Area of Science:
- Oncology
- Palliative Care
- Health Services Research
Background:
- Emergency department (ED) visits in cancer patients can signal unmet needs and suboptimal care quality.
- Outpatient palliative care may reduce ED visits and align care with patient preferences.
Purpose of the Study:
- To characterize ED visits in advanced cancer patients referred to outpatient palliative care.
- To evaluate if earlier palliative care referrals decrease end-of-life ED visits.
- To examine advance care planning completion in palliative care and ED settings.
Main Methods:
- Retrospective cohort study at a tertiary hospital in South Korea (2018-2022).
- Included patients with advanced cancer referred to outpatient palliative care.
- Analyzed factors associated with overall and end-of-life ED visits and advance care planning completion.
Main Results:
- 25.8% of 3560 patients had 1395 ED visits; 10.6% had end-of-life ED visits.
- Earlier palliative care referral correlated with more overall ED visits but fewer end-of-life ED visits.
- Advance care planning was completed in outpatient palliative care clinics more often than in EDs.
Conclusions:
- Many advanced cancer patients referred to palliative care still experience ED visits, including near end-of-life.
- Earlier palliative care integration is associated with reduced end-of-life ED visits.
- Timely palliative care is essential for improving patient outcomes and care alignment.
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