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BMC Palliative Care
Published in: BMC Palliative Care 1/2015

Open Access 01-12-2015 | Research article

Comparison of terminally ill cancer- vs. non-cancer patients in specialized palliative home care in Germany – a single service analysis

Authors: Stephanie Stiel, Maria Heckel, Andreas Seifert, Tobias Frauendorf, Roland Martin Hanke, Christoph Ostgathe

Published in: BMC Palliative Care | Issue 1/2015

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Abstract

Background

Palliative care (PC) is no longer offered with preference to cancer patients (CA), but also to patients with non-malignant, progressive diseases. Taking current death statistics into account, PC in Europe will face a growing number of patients dying from non-cancer diseases (NCA). More insights into specialized palliative home care (SPHC) in NCAs are needed.

Methods

Retrospective analysis and group comparisons between CAs and NCAs of anonymous data of all patients cared for between December 2009 and June 2012 by one SPHC team in Germany. Patient-, disease- and care-related data are documented in clinical routine by specialized PC physicians and nurses in the Information System Palliative Care 3.0 ® (ISPC®).

Results

Overall, 502 patients were cared for by the SPHC team; from 387 patients comprehensive data sets were documented. These 387 data sets (CA: N = 300, 77.5 % and NCA: N = 87, 22.5 %) are used for further analysis here. NCAs were significantly older (81 vs. 73 years; p < .001), than CAs and most often suffered from diseases of the nervous system (40 %). They needed significantly more assistance with defecation (87 vs. 74 %; p < .001) and urination (47 vs. 29 %; p < .001) and were more often affected from impaired vigilance (30 vs. 11 %; p < .001) than CAs. A by trend higher proportion of NCAs died within one day after admission to palliative home care (12 vs. 5 %; p < .05) and a smaller proportion was re-admitted to hospital during home care (6 vs. 20 %; p < .001). NCAs died predominantly in nursing homes (50 vs. 20 %; p < .001).

Conclusions

Although the proportion of NCAs was relatively high in this study, the access to PC services seems to takes place late in the disease trajectory, as demonstrated by the lower survival rate for NCAs. Nevertheless, the results show, that NCAs PC needs are as complex and intense as in CAs.
Footnotes
1
In Germany, an application to determine the need for nursing care for a certain patient is made to the Medical Service of the Health Funds (MDK). This application is followed by a face-to-face meeting between the certain patient and an employee of the MDK. This employee is authorized to evaluate the individual need for nursing care e.g. in body care, mobility, management of one’s own household. The need for nursing care in these tasks corresponds to defined time units. The sum of all time units then results in a proposal of the employee for a nursing care level to the Health Funds.
 
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Metadata
Title
Comparison of terminally ill cancer- vs. non-cancer patients in specialized palliative home care in Germany – a single service analysis
Authors
Stephanie Stiel
Maria Heckel
Andreas Seifert
Tobias Frauendorf
Roland Martin Hanke
Christoph Ostgathe
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Palliative Care / Issue 1/2015
Electronic ISSN: 1472-684X
DOI
https://doi.org/10.1186/s12904-015-0033-z

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