Aspects of outpatient palliative care in Germany - a survey among office-based physicians

Abstract

Background: Currently, palliative care is widely discussed. The aim of this study is to explore different aspects of the ambulatory treatment environment of palliative care patients and its structure in Germany from the viewpoint of caring physicians. Methods: A structured questionnaire was developed and sent to 1,003 office-based physicians in Germany. Topics were the delivery and effort of care, cooperation among health care providers, the subjective assessment of existing health care structures, the reimbursement system, as well as an assessment of future developments. Sub-group analyses were conducted. Results: Three hundred fourteen questionnaires were included in the statistical analyses. Fifty percent of physicians estimate the additional time and effort for palliative care patients compared to non-palliative care patients to be 50% and more. The best cooperation is seen with caregivers; however, cooperation with psycho-social care providers should be improved. Fifty percent describe the outpatient health care situation as (very) insufficient, but improvements are expected in the future. Ninety percent assess German reimbursement structures as (very) insufficient. Conclusions: This study gives an insight into the German outpatient health care setting for palliative care patients. Palliative care patients have higher and more complex needs with respect to health care than other patients. Further studies should focus on the collection of longitudinal patient data for more comprehensive insight.