COMPANION: development of a patient-centred complexity and casemix classification for adult palliative care patients based on needs and resource use – a protocol for a cross-sectional multi-centre study

BMC Palliative Care

Friedemann Nauck¹  Maximiliane Jansky¹  Farina Hodiamont²  Daniela Gesell²  Claudia Bausewein²  Julia Wikert²  Steven Kranz³  Reiner Leidl⁴  Caroline Schatz⁴  Anne-Laure Boulesteix⁵ 

[1] Clinic for Palliative Medicine, University Medical Center, Göttingen, Germany;Department of Palliative Medicine, LMU University Hospital, Munich, Germany;German Association for Palliative Medicine, Berlin, Germany;Helmholtz Zentrum München, Institute of Health Economics and Health Care Management, Munich, Germany;Ludwig-Maximilians-Universität München, LMU Munich School of Management, Institute of Health Economics and Health Care Management, Munich, Germany;Ludwig-Maximilians-Universität München, Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Munich, Germany;

关键词: Palliative care;    End of life care;    Casemix classification;    Cost calculation;    CART analysis;   

DOI  :  10.1186/s12904-021-00897-x

来源: Springer

【 摘 要 】

BackgroundA casemix classification based on patients’ needs can serve to better describe the patient group in palliative care and thus help to develop adequate future care structures and enable national benchmarking and quality control. However, in Germany, there is no such an evidence-based system to differentiate the complexity of patients’ needs in palliative care. Therefore, the study aims to develop a patient-oriented, nationally applicable complexity and casemix classification for adult palliative care patients in Germany.MethodsCOMPANION is a mixed-methods study with data derived from three subprojects. Subproject 1: Prospective, cross-sectional multi-centre study collecting data on patients’ needs which reflect the complexity of the respective patient situation, as well as data on resources that are required to meet these needs in specialist palliative care units, palliative care advisory teams, and specialist palliative home care. Subproject 2: Qualitative study including the development of a literature-based preliminary list of characteristics, expert interviews, and a focus group to develop a taxonomy for specialist palliative care models. Subproject 3: Multi-centre costing study based on resource data from subproject 1 and data of study centres. Data and results from the three subprojects will inform each other and form the basis for the development of the casemix classification. Ultimately, the casemix classification will be developed by applying Classification and Regression Tree (CART) analyses using patient and complexity data from subproject 1 and patient-related cost data from subproject 3.DiscussionThis is the first multi-centre costing study that integrates the structure and process characteristics of different palliative care settings in Germany with individual patient care. The mixed methods design and variety of included data allow for the development of a casemix classification that reflect on the complexity of the research subject. The consecutive inclusion of all patients cared for in participating study centres within the time of data collection allows for a comprehensive description of palliative care patients and their needs. A limiting factor is that data will be collected at least partly during the COVID-19 pandemic and potential impact of the pandemic on health care and the research topic cannot be excluded.Trial registrationGerman Register for Clinical Studies trial registration number: DRKS00020517.

【 授权许可】

CC BY