A significant number of patients undergoing specialist community palliative care experience emergency department presentations or unplanned hospitalizations. Identifying the underlying drivers of these events is critical for designing person-centered solutions. To determine the underlying causes of unplanned hospitalizations for individuals enrolled in specialist community palliative care services. A scoping review registered with PROSPERO (CRD42024495016) was conducted and reported in accordance with the PRISMA extension for scoping reviews. Academic databases, including Scopus, Embase, PubMed, and CINAHL, were searched for literature published between 2014 and 2025. Screening of titles, abstracts, and full texts, along with data extraction, was conducted by two independent reviewers. Extracted drivers for hospitalization were inductively coded using content analysis to generate a descriptive overview of the data. 13 out of 2482 retrieved studies met the eligibility criteria. Six core categories regarding the reasons for hospitalization emerged: (1) unrelieved symptoms (comprising 16 subcategories), (2) acute events (comprising five subcategories), (3) indicators of clinical deterioration, (4) patient or caregiver distress/exhaustion, (5) misconceptions regarding goals of care, and (6) other/unknown causes. Among the subcategories, the most regularly documented drivers for admission were dyspnoea (n = 11 studies, 85%), pain (n = 9, 69%), gastrointestinal symptoms (n = 9, 69%), and infection (n = 7, 54%). Comparative studies (n = 5) evaluating specialist palliative care compared with standard or absent palliative care demonstrated inconsistent hospitalization outcomes and provided limited statistical detail. Despite differences in data-collection techniques, this scoping review offers valuable insights into hospitalization trends. These findings establish a baseline for developing precise service enhancements that help patients remain at home for longer periods during their final year of life.
