{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:33:03Z","timestamp":1790688783895,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Helsinki University Hospital Comprehensive Cancer Centre, State Research Funding","award":["TYH2024220"],"award-info":[{"award-number":["TYH2024220"]}]},{"DOI":"10.13039\/501100010711","name":"Cancer Foundation Finland","doi-asserted-by":"publisher","award":["70419"],"award-info":[{"award-number":["70419"]}],"id":[{"id":"10.13039\/501100010711","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Helsinki University Library"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Non-malignant diseases cause 60% of non-communicable diseases requiring palliative care, yet specialist palliative care services primarily focus on cancer. We investigated end-of-life healthcare and social services utilization among cancer and non-malignant patients, and, secondarily, access to specialist palliative care and its effect on services utilization. This retrospective, nationwide register-based study included all adults (n\u2009=\u200938\u2009540) who died from non-communicable life-limiting diseases in Finland in 2019, categorized into neurodegenerative (31%), other non-malignant (36%), and cancer (33%) groups. Hospital was the most common place of death (61%). Healthcare utilization substantially increased during the final weeks of life in all groups but remained highest in cancer patients. Social services utilization was highest in neurodegenerative diseases. Specialist palliative care contact was significantly (P\u2009&amp;lt;\u2009.001) higher in cancer (30.1%) compared to neurodegenerative (10.9%) and other non-malignant (7%) diseases. Early (&amp;gt;30\u2009days before death) compared to late\/no specialist palliative care contact significantly reduced emergency care contacts (47.8% vs. 52.2%) and hospitalizations in secondary hospitals (24.7% vs. 33.7%), and increased specialist palliative care ward (15.5% vs. 1.5%) and hospital-at-home (36.8% vs. 3.4%) utilization during the final month (P\u2009&amp;lt;\u2009.001). Healthcare utilization was high in all disease groups, highest among cancer patients. Hospital was the most common place of death. Specialist palliative care contact was rare in non-malignant diseases. Early contact with specialist palliative care associated with lower emergency care utilization and secondary hospital inpatient care during the last month of life. These results highlight the necessity for timely equitable specialist palliative care services for all.<\/jats:p>","DOI":"10.1093\/eurpub\/ckaf044","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T08:58:39Z","timestamp":1748422719000},"page":"828-834","source":"Crossref","is-referenced-by-count":20,"title":["Impact of specialist palliative care on utilization of healthcare and social services at the end-of-life: a nationwide register-based cohort study"],"prefix":"10.1093","volume":"35","author":[{"given":"Satu E","family":"Ahtiluoto","sequence":"first","affiliation":[{"name":"Palliative Care Center, Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki , Helsinki,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0117-8559","authenticated-orcid":false,"given":"Timo P","family":"Carp\u00e9n","sequence":"additional","affiliation":[{"name":"Palliative Care Center, Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki , Helsinki,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pirita T","family":"Forsius","sequence":"additional","affiliation":[{"name":"The Department of Healthcare and Social Welfare, Finnish Institute for Health and Welfare , Helsinki,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikko S J","family":"Nuutinen","sequence":"additional","affiliation":[{"name":"Nordic Healthcare Group , Helsinki,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelli-Sofia A","family":"N\u00e5hls","sequence":"additional","affiliation":[{"name":"Department of Oncology, Vaasa Central Hospital, The Wellbeing Services County of Ostrobothnia , Vaasa,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauliina M","family":"Kitti","sequence":"additional","affiliation":[{"name":"Department of Oncology, Comprehensive Cancer Centre, Helsinki University Hospital and University of Helsinki , Helsinki,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teija H","family":"Hammar","sequence":"additional","affiliation":[{"name":"The Department of Healthcare and Social Welfare, Finnish Institute for Health and Welfare , Helsinki,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harriet U","family":"Finne-Soveri","sequence":"additional","affiliation":[{"name":"The Department of Healthcare and Social Welfare, Finnish Institute for Health and Welfare , Helsinki,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiina H","family":"Saarto","sequence":"additional","affiliation":[{"name":"Palliative Care Center, Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki , Helsinki,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"2025101607023346100_ckaf044-B1","author":"Ritchie","year":"2023"},{"key":"2025101607023346100_ckaf044-B2","author":"Connor","year":"2020"},{"key":"2025101607023346100_ckaf044-B3","author":"WHO","year":"2019"},{"key":"2025101607023346100_ckaf044-B4","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1177\/014107680509801111","article-title":"Palliative care in non-malignant diseases","volume":"98","author":"Traue","year":"2005","journal-title":"J R Soc Med"},{"key":"2025101607023346100_ckaf044-B5","doi-asserted-by":"crossref","first-page":"765","DOI":"10.31128\/AJGP-07-18-4625","article-title":"Palliative care for the patient without cancer","volume":"47","author":"Mounsey","year":"2018","journal-title":"Aust J Gen 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