Palliative care utilization and outcomes in older Thai patients with cholangiocarcinoma: a national study, 2017–2024

Palliative care (PC) is a critical component of the management of advanced cholangiocarcinoma (CCA), particularly in elderly patients. This study aimed to determine the prevalence of PC utilization among hospitalized older adults with CCA in Thailand and to evaluated temporal trends in PC utilization from 2017 to 2024. A retrospective analysis was conducted using de-identified inpatient data from the National Health Security Office (NHSO) of Thailand database covering the period 2017–2024. Hospitalizations of patients aged 60 years or older with a primary diagnosis of CCA (ICD-10-TM codes C22.1 and C24) were included. PC utilization was identified using ICD-10-TM code Z51.5. Of 83,688 hospitalizations of older patients with CCA, 16.9% ( n = 14,154) had PC encounter. PC utilization was significantly associated with age > 80 years, intrahepatic CCA, and the North and Northeast regions ( p < 0.05). PC utilization was significantly associated with higher odds of receiving blood transfusion (aOR 1.36), endotracheal intubation (aOR 1.61), percutaneous catheter drainage (aOR 2.96), and radiotherapy (aOR 2.26). Length of stay exceeding 5 days (aOR 2.13), higher healthcare costs (aOR 1.50), and death at hospital discharge (aOR 4.06) were significantly associated with documented PC utilization. PC services were documented in only 16.9% of elderly CCA hospitalizations in Thailand, with higher uptake observed among the oldest patients, those with intrahepatic CCA, and those in the North and Northeast regions.