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An emergency department visit during the last month of life was needed in 34% of patients with and 48% without the protocol (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.002). The mean number of emergency department visits for patients with and without the protocol was 0.47 and 0.75, respectively (RR 0.55 [95% Cl: 0.47\u20130.67],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001 in Poisson regression analysis). During the last 30 days of life, patients in the protocol spent more time at home (median of 21 vs. 11 days,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001) and died more often at home (26% vs. 4%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Including paramedics in the end-of-life care pathway is associated with decreased emergency department visits during the last month of life and increased time spent at home, including at the time of death. Therefore, this integration of paramedics seems to direct health care resources more beneficially while honoring most patients\u2019 preference to stay at home.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10966218261471232","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:36:28Z","timestamp":1784698588000},"page":"1671-1679","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrating Paramedics into End-of-Life Care Increases Cancer Patients\u2019 Time Spent at Home Instead of the Emergency Room: A Retrospective Cohort Study"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6444-0158","authenticated-orcid":false,"given":"Leena K.","family":"Surakka","sequence":"first","affiliation":[{"name":"University of Eastern Finland, Institute of Public Health and Clinical Nutrition, Kuopio, Finland."},{"name":"Wellbeing services county of North Karelia Siun sote, Palliative care center, Joensuu, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuomas","family":"Selander","sequence":"additional","affiliation":[{"name":"Science service center, Kuopio University hospital, Wellbeing services county of North Savo, Kuopio, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pekka","family":"M\u00e4ntyselk\u00e4","sequence":"additional","affiliation":[{"name":"University of Eastern Finland, Institute of Public Health and Clinical Nutrition, Kuopio, Finland."},{"name":"Teaching Clinic, Kuopio University hospital, Wellbeing services county of North Savo, Kuopio, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juho T.","family":"Lehto","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland."},{"name":"Palliative Care Centre and Home Hospital Services, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2021.100225"},{"issue":"1","key":"e_1_3_3_3_1","first-page":"22","article-title":"White Paper on standards and norms for hospice and palliative care in Europe: Part 2","volume":"17","author":"Radbruch L","unstructured":"2.Radbruch L, , Payne S. 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