8. Outcomes: health systems impacts (costs, service use).

Secondary outcomes: health systems impacts (costs of care, hospital (re)admissions)
Study ID	Costs	Hospital (re)admissions	Consultation length	Treatments and hospice use	Timing (longest follow‐up)	Scale, scoring
Agar 2017	X Training, CC and routine healthcare costs	‐	‐	‐	‐	Cost utility (benefit estimated as QALYs). QoL for economic analyses assessed by nurse‐rated EQ‐5D‐5L No data
Clayton 2007	‐	‐	X	‐	‐	‐
Epstein 2017	‐	‐	‐	X	‐	Treatments and hospice use in last month of life; medical records, composite score of 3 indicators of aggressive treatment in last 30 days of life: chemotherapy, potentially burdensome interventions, ED/hospital admission) and hospice utilization
Walczak 2017	‐	‐	X	‐	‐

X: outcome assessed; ‐: outcome not reported.

Data from Epstein 2017 (composite of treatments and hospice use in last month of life) was judged as clinical, rather than primarily related to communication; data were not extracted on this outcome for the review.

CC: case conference; ED: emergency department; QoL: quality of life; QALY: quality‐adjusted life‐year.