“…The PMSI database historically underestimated palliative care delivery. The PMSI-based economic evaluation of hospital stays' costs has supported an increasing use of the ICD-10 palliative care code (Z515) since 2004, particularly in medical, surgery and obstetrics services (55). Two recent studies based on this code showed that the proportions of cancer patients referred to HPC (52% and 57%) was very similar to the estimated proportion of dying patients requiring palliative care (63%) (6,7,56).…”