Emergency Department-Initiated Palliative Care Consultations for Patients with Cancer: Utilization Patterns, Clinical Characteristics, and Longitudinal Trends

Document Type

Article

Publication Date

9-1-2026

Publication Title

The Journal of emergency medicine

Keywords

Humans, Palliative Care, Female, Retrospective Studies, Neoplasms, Emergency Service, Hospital, Male, Aged, Referral and Consultation, Middle Aged, Aged, 80 and over, United States, Emergency Room Visits, COVID-19, Longitudinal Studies

Abstract

BACKGROUND: Early integration of palliative care is recommended for patients with cancer, yet little is known about how these recommendations translate into routine clinical practice in emergency departments (EDs).

OBJECTIVES: To evaluate trends in ED-initiated hospice and palliative care (HPC) consultations among patients with cancer and characterize utilization patterns and clinical profiles.

METHODS: We conducted a retrospective cohort study using electronic medical record data from January 1, 2016, to December 31, 2023, across five hospitals within a large integrated health system in the United States. Adult patients (≥18 years) with cancer-related ED diagnoses who received an ED-initiated hospice or palliative care consultation were included. Primary outcomes included annual consultation trends, clinical characteristics, and patterns of inpatient utilization.

RESULTS: The cohort included 2639 unique patients across 2894 cancer-related ED encounters, with a total of 3407 HPC consultations. Mean (standard deviations) age was 72.7 (13.8) years. Hospital admission occurred in 92.4% of encounters, with 53.3% resulting in in-hospital death. ED-initiated consultations increased 388% from 2016 to 2023 and 86.3% following the onset of the COVID-19 pandemic. The proportion of hospital-wide cancer-related consultations originating in the ED increased from 6.7% in 2016 to 12.9% in 2023.

CONCLUSION: ED-initiated HPC consultations for patients with cancer increased substantially over 8 years, suggesting growing integration of specialty palliative care services within emergency care for oncology patients.

Medical Subject Headings

Humans; Palliative Care; Female; Retrospective Studies; Neoplasms; Emergency Service, Hospital; Male; Aged; Referral and Consultation; Middle Aged; Aged, 80 and over; United States; Emergency Room Visits; COVID-19; Longitudinal Studies

PubMed ID

42508307

Volume

88

First Page

58

Last Page

70

Find It @ Sladen

Share

COinS