{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T16:50:28Z","timestamp":1784739028589,"version":"3.55.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Finland State research funding","award":["TYH2024220"],"award-info":[{"award-number":["TYH2024220"]}]},{"DOI":"10.13039\/501100010711","name":"Sy\u00f6p\u00e4s\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010711","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Helsinki University Hospital Comprehensive Cancer Centre"},{"DOI":"10.13039\/100007797","name":"University of Helsinki","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007797","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Breast Cancer"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The incidence of breast cancer and the related mortality in Finland are among the highest in the world. Specialist palliative care (SPC) has been shown to improve quality of life and potentially reduce intensive resource use at the end of life among patients with advanced cancer. We aimed to perform a nationwide evaluation of the timing of the first SPC contact and its impact on hospital resource utilization in patients with breast cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A nationwide retrospective cohort analysis included 881 breast cancer patients who died in Finland in 2019, with data drawn from national registries. Patients were divided into two groups according to the time of their first SPC contact: Group I (&gt;\u200930\u00a0days before death) and Group II (\u2264\u200930\u00a0days before death or no SPC contact).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>SPC contact was established for 288 (35%) patients, with a median interval of 89\u00a0days from initial SPC contact to death. During the last month of life, patients in Group I had fewer emergency department contacts (46% vs. 58%, p\u2009=\u20090.004) and fewer hospitalizations in secondary care (28% vs. 48%, p\u2009&lt;\u20090.001), compared patients in Group II. Additionally, patients in Group I utilized hospital-at-home services more often (42% vs. 7%, p\u2009&lt;\u20090.001) and had a higher likelihood of dying in SPC wards (15% vs. 3%, p\u2009&lt;\u20090.001) rather than in hospital (65% vs. 77%, p\u2009&lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Timely SPC contact was associated with fewer acute hospital contacts and a reduced likelihood of hospital death, underscoring the importance of timely palliative care integration for patients with advanced breast cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12282-025-01759-7","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T10:13:15Z","timestamp":1755166395000},"page":"1346-1353","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The impact of specialist palliative care on healthcare utilization among patients with breast cancer: a nationwide register-based cohort study"],"prefix":"10.1007","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0973-9161","authenticated-orcid":false,"given":"Nelli-Sofia","family":"N\u00e5hls","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Carp\u00e9n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikko","family":"Nuutinen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiina","family":"Saarto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,14]]},"reference":[{"key":"1759_CR1","unstructured":"Ferlay J, Ervik M, Lam F, Laversanne M, Colombet M, Mery L, et al. 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The study was performed with the Finnish Institute for Health and Welfare (THL) as part of the Project on Quality Information on Palliative Care and End-of-life Care. The study was approved by THL Dnr: 12345556. According to the Finnish legislation for research, no separate ethics committee approval was needed, as data used in the study consisted of deceased patients. All data was anonymized before its use. We confirm that all procedures were carried out in accordance with relevant guidelines and regulations.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Not applicable, data included only deceased patients.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}