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Background The concept of cost-effectiveness is necessary for optimal utilization of limited health care resources. However, few studies have assessed the cost-effectiveness of palliative care using quality-adjusted life years (QALYs), considered common outcomes in health economics. Objective We aimed to perform a cost-effectiveness analysis of palliative care for terminal cancer patients by using QALYs. Design A retrospective cohort study was performed. Setting/Patients We included 401 patients with stage IV cancer, who were hospitalized and