Specialist Palliative Care and the Use of Healthcare Services Among Patients With Multiple Myeloma: A Nationwide Cohort Study

Abstract

<h3>Objectives</h3><p>To investigate the access to specialist palliative care (SPC) and its impact on healthcare utilization at the end of life in patients with multiple myeloma (MM).</p><h3>Methods</h3><p>This retrospective cohort study examined all Finnish patients who died of MM in 2019. Data were collected from national health databases. Patients were categorized by whether they had contact with SPC or not.</p><h3>Results</h3><p>We identified 278 patients (median age at death 77.5 years, 44.2% male), of whom 23.4% had SPC contact a median of 38 days before death. During the last 6 months of life, 92.4% of all patients had contact with the emergency department, 83.5% were hospitalized in secondary care, and 65.5% were hospitalized in primary care hospitals. Patients with SPC contact had fewer emergency department visits (50.8% vs. 65.3%, <em>p</em> = 0.041) and hospitalizations in secondary care (41.5% vs. 62.0%, <em>p</em> = 0.004) in the last month of life and fewer hospital deaths (69.2% vs. 84.0%, <em>p</em> = 0.012).</p><h3>Conclusions</h3><p>Despite high healthcare service utilization at the end of life, access to SPC was often limited and late. Contact with SPC reduced acute healthcare utilization at the end of life, indicating better end-of-life care.</p>