{"id":"https://openalex.org/W7225006872","doi":"https://doi.org/10.1186/s12904-026-02408-2","title":"End-of-life care practices among internal medicine inpatient deaths in 2014 and 2023: a retrospective comparative study","display_name":"End-of-life care practices among internal medicine inpatient deaths in 2014 and 2023: a retrospective comparative study","publication_year":2026,"publication_date":"2026-10-31","ids":{"openalex":"https://openalex.org/W7225006872","doi":"https://doi.org/10.1186/s12904-026-02408-2"},"language":"en","primary_location":{"id":"doi:10.1186/s12904-026-02408-2","doi":"https://doi.org/10.1186/s12904-026-02408-2","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12904-026-02408-2","pdf_url":null,"source":{"id":"https://openalex.org/S169992948","display_name":"BMC Palliative Care","issn_l":"1472-684X","issn":["1472-684X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Palliative Care","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1186/s12904-026-02408-2","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5029193020","display_name":"Hui Sin Cheng","orcid":"https://orcid.org/0009-0008-8811-4075","observed_orcids":["https://orcid.org/0009-0008-8811-4075","https://orcid.org/0000-0002-7530-2244"]},"institutions":[{"id":"https://openalex.org/I2251586001","display_name":"Singapore General Hospital","ror":"https://ror.org/036j6sg82","country_code":"SG","type":"healthcare","lineage":["https://openalex.org/I2251586001"]}],"countries":["SG"],"is_corresponding":true,"raw_author_name":"Hui Sin Cheng","raw_affiliation_strings":["Department of Internal Medicine, Singapore General Hospital, Singapore, Singapore"],"raw_orcid":"https://orcid.org/0009-0008-8811-4075","affiliations":[{"raw_affiliation_string":"Department of Internal Medicine, Singapore General Hospital, Singapore, Singapore","institution_ids":["https://openalex.org/I2251586001"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160241430","display_name":"Jason Tian En Tay","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210159875","display_name":"Sengkang General Hospital","ror":"https://ror.org/05cqp3018","country_code":"SG","type":"healthcare","lineage":["https://openalex.org/I4210159875"]}],"countries":["SG"],"is_corresponding":false,"raw_author_name":"Jason Tian En Tay","raw_affiliation_strings":["Department of Internal Medicine, Sengkang General Hospital, Singapore, Singapore"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Internal Medicine, Sengkang General Hospital, Singapore, Singapore","institution_ids":["https://openalex.org/I4210159875"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5109263182","display_name":"Mei Ling Kang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2251586001","display_name":"Singapore General Hospital","ror":"https://ror.org/036j6sg82","country_code":"SG","type":"healthcare","lineage":["https://openalex.org/I2251586001"]}],"countries":["SG"],"is_corresponding":false,"raw_author_name":"Mei Ling Kang","raw_affiliation_strings":["Department of Internal Medicine, Singapore General Hospital, Singapore, Singapore"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Internal Medicine, Singapore General Hospital, Singapore, Singapore","institution_ids":["https://openalex.org/I2251586001"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5086787860","display_name":"Xiaohui Xin","orcid":"https://orcid.org/0000-0002-4171-753X","observed_orcids":["https://orcid.org/0000-0002-4171-753X","https://orcid.org/0000-0001-9942-7300"]},"institutions":[{"id":"https://openalex.org/I2251586001","display_name":"Singapore General Hospital","ror":"https://ror.org/036j6sg82","country_code":"SG","type":"healthcare","lineage":["https://openalex.org/I2251586001"]}],"countries":["SG"],"is_corresponding":false,"raw_author_name":"Xiaohui Xin","raw_affiliation_strings":["Health Services Research Unit, Singapore General Hospital, Singapore, Singapore"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Health Services Research Unit, Singapore General Hospital, Singapore, Singapore","institution_ids":["https://openalex.org/I2251586001"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160243924","display_name":"Laura Fang Yi Soo","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2251586001","display_name":"Singapore General Hospital","ror":"https://ror.org/036j6sg82","country_code":"SG","type":"healthcare","lineage":["https://openalex.org/I2251586001"]}],"countries":["SG"],"is_corresponding":false,"raw_author_name":"Laura Fang Yi Soo","raw_affiliation_strings":["Healthcare Management Executive Unit, Singapore General Hospital, Singapore, Singapore"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Healthcare Management Executive Unit, Singapore General Hospital, Singapore, Singapore","institution_ids":["https://openalex.org/I2251586001"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5027647584","display_name":"Yi Zhou","orcid":"https://orcid.org/0000-0001-5429-4794","observed_orcids":["https://orcid.org/0000-0001-5429-4794"]},"institutions":[{"id":"https://openalex.org/I2251586001","display_name":"Singapore General Hospital","ror":"https://ror.org/036j6sg82","country_code":"SG","type":"healthcare","lineage":["https://openalex.org/I2251586001"]}],"countries":["SG"],"is_corresponding":false,"raw_author_name":"Yi Zhou","raw_affiliation_strings":["Department of Internal Medicine, Singapore General Hospital, Singapore, Singapore"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Internal Medicine, Singapore General Hospital, Singapore, Singapore","institution_ids":["https://openalex.org/I2251586001"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5079355451","display_name":"Natalie Liling Woong","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2251586001","display_name":"Singapore General Hospital","ror":"https://ror.org/036j6sg82","country_code":"SG","type":"healthcare","lineage":["https://openalex.org/I2251586001"]}],"countries":["SG"],"is_corresponding":false,"raw_author_name":"Natalie Liling Woong","raw_affiliation_strings":["Department of Internal Medicine, Singapore General Hospital, Singapore, Singapore"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Internal Medicine, Singapore General Hospital, Singapore, Singapore","institution_ids":["https://openalex.org/I2251586001"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5052461534","display_name":"Guozhang Lee","orcid":"https://orcid.org/0000-0003-3671-3697","observed_orcids":["https://orcid.org/0000-0003-3671-3697"]},"institutions":[{"id":"https://openalex.org/I2251586001","display_name":"Singapore General Hospital","ror":"https://ror.org/036j6sg82","country_code":"SG","type":"healthcare","lineage":["https://openalex.org/I2251586001"]}],"countries":["SG"],"is_corresponding":false,"raw_author_name":"Guozhang Lee","raw_affiliation_strings":["Department of Internal Medicine, Singapore General Hospital, Singapore, Singapore"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Internal Medicine, Singapore General Hospital, Singapore, Singapore","institution_ids":["https://openalex.org/I2251586001"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5029193020"],"corresponding_institution_ids":["https://openalex.org/I2251586001"],"apc_list":{"value":2990,"currency":"USD","value_usd":2990},"apc_paid":{"value":2990,"currency":"USD","value_usd":2990},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.87360207,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10177","display_name":"Palliative Care and End-of-Life Issues","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10177","display_name":"Palliative Care and End-of-Life Issues","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13340","display_name":"Palliative and Oncologic Care","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11199","display_name":"Pain Management and Opioid Use","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2703","display_name":"Anesthesiology and Pain Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/end-of-life-care","display_name":"end-of-life care","score":0.984000027179718},{"id":"https://openalex.org/keywords/inpatient-deaths","display_name":"inpatient deaths","score":0.6729999780654907},{"id":"https://openalex.org/keywords/internal-medicine","display_name":"internal medicine","score":0.8450000286102295},{"id":"https://openalex.org/keywords/advance-care-planning","display_name":"advance care planning","score":0.9909999966621399},{"id":"https://openalex.org/keywords/goals-of-care-conversations","display_name":"goals of care discussions","score":0.8309999704360962},{"id":"https://openalex.org/keywords/health-care-utilization","display_name":"health care utilization","score":0.8199999928474426},{"id":"https://openalex.org/keywords/inotropic-support","display_name":"inotropic support","score":0.7979999780654907},{"id":"https://openalex.org/keywords/functional-status","display_name":"functional status","score":0.7590000033378601},{"id":"https://openalex.org/keywords/homebound-patients","display_name":"homebound patients","score":0.8410000205039978},{"id":"https://openalex.org/keywords/multimorbidity","display_name":"multimorbidity","score":0.8500000238418579},{"id":"https://openalex.org/keywords/temporal-trends","display_name":"temporal trends","score":0.6710000038146973}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8797000050544739},{"id":"https://openalex.org/C2776135927","wikidata":"https://www.wikidata.org/wiki/Q5242559","display_name":"Referral","level":2,"score":0.7240999937057495},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.6141999959945679},{"id":"https://openalex.org/C2994186709","wikidata":"https://www.wikidata.org/wiki/Q29483","display_name":"Palliative care","level":2,"score":0.6021000146865845},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.5479999780654907},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.5149000287055969},{"id":"https://openalex.org/C2775909303","wikidata":"https://www.wikidata.org/wiki/Q3259564","display_name":"Inpatient care","level":3,"score":0.4828999936580658},{"id":"https://openalex.org/C2780283434","wikidata":"https://www.wikidata.org/wiki/Q7705274","display_name":"Tertiary referral hospital","level":3,"score":0.47940000891685486},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.4726000130176544},{"id":"https://openalex.org/C2780358146","wikidata":"https://www.wikidata.org/wiki/Q5908738","display_name":"Hospital medicine","level":2,"score":0.4332999885082245},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.39419999718666077},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.39169999957084656},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.38370001316070557},{"id":"https://openalex.org/C2991975920","wikidata":"https://www.wikidata.org/wiki/Q621261","display_name":"Pain medicine","level":3,"score":0.38370001316070557},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.37130001187324524},{"id":"https://openalex.org/C2780879335","wikidata":"https://www.wikidata.org/wiki/Q2045105","display_name":"End-of-life care","level":3,"score":0.33809998631477356},{"id":"https://openalex.org/C124306116","wikidata":"https://www.wikidata.org/wiki/Q2512965","display_name":"Ambulatory care","level":3,"score":0.3061000108718872},{"id":"https://openalex.org/C2781385661","wikidata":"https://www.wikidata.org/wiki/Q4677918","display_name":"Acute care","level":3,"score":0.28600001335144043},{"id":"https://openalex.org/C195910791","wikidata":"https://www.wikidata.org/wiki/Q1324077","display_name":"Medical record","level":2,"score":0.2802000045776367},{"id":"https://openalex.org/C17923572","wikidata":"https://www.wikidata.org/wiki/Q7250160","display_name":"Propensity score matching","level":2,"score":0.2786000072956085},{"id":"https://openalex.org/C82789193","wikidata":"https://www.wikidata.org/wiki/Q2142611","display_name":"Relative risk","level":3,"score":0.2556000053882599}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1186/s12904-026-02408-2","doi":"https://doi.org/10.1186/s12904-026-02408-2","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12904-026-02408-2","pdf_url":null,"source":{"id":"https://openalex.org/S169992948","display_name":"BMC Palliative Care","issn_l":"1472-684X","issn":["1472-684X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Palliative Care","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.1186/s12904-026-02408-2","doi":"https://doi.org/10.1186/s12904-026-02408-2","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12904-026-02408-2","pdf_url":null,"source":{"id":"https://openalex.org/S169992948","display_name":"BMC Palliative Care","issn_l":"1472-684X","issn":["1472-684X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Palliative Care","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.9940000176429749}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2889159075","https://openalex.org/W3104140438","https://openalex.org/W2886761096","https://openalex.org/W2117302034","https://openalex.org/W4407069896","https://openalex.org/W6940915231","https://openalex.org/W2948177172","https://openalex.org/W7221134184","https://openalex.org/W2075302749","https://openalex.org/W1584641754"],"abstract_inverted_index":{"Patients":[0],"admitted":[1],"under":[2,48,230],"internal":[3,21,231],"medicine":[4,22,83,182,232,269],"frequently":[5,148],"have":[6],"advanced":[7],"multimorbidity,":[8],"high":[9],"healthcare":[10,35,74,140],"utilisation":[11,36,141],"and":[12,37,61,80,116,246,258,272,290],"palliative":[13,82,181,268,282],"care":[14,39,78,215,224,249,274,283,302],"needs.":[15],"We":[16,41],"compared":[17,62],"two":[18,252],"cohorts":[19,253],"of":[20,51,103,208,287],"inpatient":[23,46,67,81],"deaths":[24,47,68],"nearly":[25,254],"a":[26,117,234,255],"decade":[27,256],"apart":[28,257],"to":[29,297],"examine":[30],"differences":[31,136,242],"in":[32,107,111,124,128,139,150,153,157,171,175,188,192,202,210,237,243],"patient":[33,244],"characteristics,":[34,73],"end-of-life":[38,77,223,248,301],"practices.":[40],"retrospectively":[42],"reviewed":[43],"50":[44,65],"consecutive":[45,66],"the":[49],"Department":[50],"Internal":[52],"Medicine":[53],"at":[54,233],"Singapore":[55],"General":[56],"Hospital":[57],"during":[58],"June\u2013July":[59],"2023":[60,88,151,211],"them":[63],"with":[64,96,101],"from":[69],"July\u2013August":[70],"2014.":[71],"Demographic":[72],"utilisation,":[75],"documented":[76,92,213],"practices":[79,225,250],"referral":[84,166,183,270],"were":[85,121,137],"compared.":[86],"The":[87,239],"cohort":[89],"had":[90,212],"poorer":[91],"premorbid":[93],"functional":[94,288],"status,":[95,289],"more":[97,168],"patients":[98,209,227],"requiring":[99],"assistance":[100],"activities":[102],"daily":[104],"living":[105],"(26%":[106],"2014":[108,125,154,172,189],"vs.":[109,126,155,173,190],"52%":[110],"2023,":[112,129,158,176,193],"p":[113,130,159,177,194],"=":[114,131,160,178,195],"0.013)":[115],"greater":[118],"proportion":[119],"who":[120,228],"homebound":[122],"(8.5%":[123],"44%":[127],"0.001).":[132],"No":[133],"statistically":[134],"significant":[135],"observed":[138],"between":[142,251],"cohorts.":[143],"Inotropic":[144],"support":[145],"was":[146,167,184],"less":[147],"used":[149],"(18%":[152,170],"2%":[156],"0.008),":[161],"whereas":[162],"medical":[163],"social":[164],"work":[165],"frequent":[169],"40%":[174],"0.015).":[179],"Inpatient":[180],"numerically":[185],"lower":[186],"(32%":[187],"16%":[191,207],"0.061).":[196],"Documented":[197],"goals-of-care":[198],"discussions":[199],"remained":[200],"common":[201],"both":[203],"cohorts,":[204],"although":[205],"only":[206],"advance":[214,273],"planning.":[216,275],"This":[217],"study":[218],"provides":[219],"contemporary":[220],"insights":[221],"into":[222],"among":[226],"died":[229],"tertiary":[235],"hospital":[236],"Singapore.":[238],"findings":[240],"describe":[241],"characteristics":[245],"selected":[247],"identify":[259],"important":[260],"areas":[261],"for":[262,292],"future":[263,300],"investigation,":[264],"including":[265],"multidisciplinary":[266],"care,":[267],"practices,":[271],"Larger":[276],"prospective":[277],"multicentre":[278],"studies":[279],"incorporating":[280],"community-based":[281],"data,":[284],"standardised":[285],"measures":[286],"adjustment":[291],"case":[293],"mix":[294],"are":[295],"needed":[296],"better":[298],"inform":[299],"delivery.":[303]},"counts_by_year":[],"updated_date":"2026-11-03T10:50:19.383937","created_date":"2026-11-01T00:00:00"}