Accessibility to specialist palliative care services in Germany: a geographical network analysis

BMC Health Services Research

Research

Daniela Gesell¹  Farina Hodiamont¹  Claudia Bausewein¹  Daniela Koller² 

[1] Department of Palliative Medicine, LMU University Hospital, LMU Munich, Munich, Germany;Institute of Medical Data Processing, Biometrics and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany;

关键词: Accessibility;    Specialist palliative care;    Geographical network analysis;    GIS;   

DOI  :  10.1186/s12913-023-09751-7

 received in 2023-02-22, accepted in 2023-06-26,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe need for palliative care will increase over the next years because of the rise in deaths from chronic illness and demographic changes. The provision of specialist palliative care (SPC) in Germany (palliative care units (PCU), specialist palliative home care (SPHC) teams and palliative care advisory (PCA) teams) has been expanded in recent years. Despite the increasing availability, there is still insufficient coverage with long travel times. The aim was to describe the spatial distribution of SPC services in Germany, to calculate the potential accessibility of facilities and to assess potential spatial under-provision.MethodsRetrospective cross-sectional study with regional analysis of SPC services in Germany. Addresses of SPC services registered online were geocoded, accessibility and network analyses were conducted, and proportion of the population living up to 60 minutes driving time were calculated.ResultsA total of 673 facilities were included. Their distribution is heterogeneous with every fourth of the 401 districts (110/401; 27.4%) lacking a SPC service. In half of the area of Germany the existing PCU and SPHC teams are within reach of 30 minutes, with nearly 90% of the population living there. Hospitals providing PCA teams can be reached within 30 minutes in 17% of the total area with provision for 43% of the population.ConclusionsA high coverage of SPHC teams and PCU indicates a good spatial distribution in Germany but no complete adequate provision of SPC services, especially for PCA teams. There is a persistent need for further implementation of hospital PCA teams.

【 授权许可】

CC BY   
© The Author(s) 2023

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