End-of-life care in Germany: Study design, methods and first results of the EPACS study (Establishment of Hospice and Palliative Care Services in Germany)

BMC Palliative Care

Research Article

Matthias Claus¹  Michael Unrath¹  Tanja Martini¹  Eva Münster¹  Luis Carlos Escobar Pinzón¹  Sabine Fischbeck²  Martin Weber³ 

[1] Institute of OccupationalSocial and Environmental Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Obere Zahlbacher Straße 67, 55131, Mainz, Germany;University Medical Center of the Johannes Gutenberg University of Mainz, Clinic of Psychosomatic Medicine and Psychotherapy, Medical Psychology and Medical Sociology, Saarstraße 21, 55099, Mainz, Germany;University Medical Center of the Johannes Gutenberg University of Mainz, Interdisciplinary Palliative Care Unit, Langenbeckstraße 1, 55131, Mainz, Germany;

关键词: Palliative Care;    Home Care;    Palliative Care Service;    Deceased Person;    Palliative Home Care;   

DOI  :  10.1186/1472-684X-9-16

 received in 2010-02-11, accepted in 2010-07-30,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundIn order to tackle the deficits in the provision of palliative home care, profound structural changes in the outpatient sector were introduced by law in Germany in 2007. The EPACS study was carried out (Research Accompanying the Establishment of Hospice and Palliative Care Services in Rhineland-Palatinate, Germany) to document the quality of inpatient and outpatient end-of-life care in Rhineland-Palatinate, Germany, before the implementation of these changes. With this article we focus on the study design and methods of the EPACS-Study. We further report first results regarding several aspects of outpatient end-of-life care.MethodsThe cross-sectional survey was based on a random sample of 5000 inhabitants of Rhineland-Palatinate that had died from May 25 until August 24 of the year 2008. Relatives of these randomly drawn deceased persons were interviewed by means of a written survey.ResultsThe overall response proportion considering only those questionnaires that actually were delivered (n = 3833) was 36.0%. Factors influencing participation were age, sex, and marital status. 355 (25.8%) deceased persons had used professional home care in the four weeks prior to their death, but only very few persons had used a specialised palliative home care service (n = 30; 8.5%). There was a clear gap between the need for specialised outpatient care and the actual utilisation of these services.ConclusionsSatisfaction with professional home care was relatively high, but physicians were rated less favourable than nurses. There were deficits especially with respect to physicians' communicative and supportive skills. Further analyses are necessary to provide more detailed information about quality of care in different care settings and for distinct groups. Predictors of good care, as well as obstacles to it, must be further investigated. In the long run, a follow-up survey must be conducted to compare quality of home care before and after the structural changes in Germany.

【 授权许可】

Unknown   
© Pinzón et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.