“Where does all the time go?”
29th June 2026
A new metric can show the impact of palliative care towards the end of life
Researchers have developed a metric that records the time spent in hospital and clinic visits, while accounting for the scarcity of time in those approaching the end of life.
Spending time in a hospital or clinic is often used as a measure of treatment burden in cancer clinical trials. But this so-called ‘time toxicity’ doesn’t account for how much time remains – it is not ‘end-weighted’.
Researchers developed a metric, ‘end-weighted time toxicity’ that measures the proportion of remaining days taken up with hospital/clinic visits. It divides the number of healthcare visit days by the number of remaining days, and is measured in ‘toxiles’. Researchers used this to explore how palliative care can impact healthcare use towards the end of life.
In this retrospective study, researchers included data from 192 deceased patients with cancer, who had been referred to a palliative care service in Sweden. Most people (146) received palliative care, while 46 never did.
The study found that people who received palliative care had fewer mean toxiles (0.52) than those who did not (0.97). In other words, people who received palliative care had fewer remaining days taken up with non-palliative-care-related hospital and clinic visits.
The study shows that receiving palliative care can reduce the amount of burdensome healthcare use in the diminishing amount of time patients have left. This improves quality of life and delivers health economic benefits for the healthcare system.
Jacobsen J, Mahajan S, Ekstrand J, Boo Hammas K, May P, Klintman J. Accounting for the Scarcity of Time as Patients Approach End of Life: The Construction of End-Weighted Time Toxicity. Value Health 2026 May;29(5):831-839. https://doi.org/10.1016/j.jval.2025.12.010.