Lux E A, Hofmeister U, Bornemann R
Dtsch Med Wochenschr. 2016 Apr;141(8):e67-72. doi: 10.1055/s-0041-106677. Epub 2016 Apr 14.
Since 2009, based on an agreement to implement palliative care for terminally ill patients at home in Westfalia-Lippe, family doctors and palliative doctors cooperate, supported by coordinators.
Since 2009, this cooperation is evaluated, concerning supply structure, number of patients and their places of death.
In Westfalia-Lippe, yearly approx. 91.000 patients die, approx. 19 % of them, 17.699 patients, were included in palliative care structures, compared to some 6 % in 2009/2010. Whereas in the first years about 70 % of the palliative patients died at home, 2014 this number increased to 75 %. Only 9 % of our patients 2014 died in a hospital (normal ward) - compared to about 13 % in 2009/2010. This applies both for urban and rural areas.
The idea of home based, family doctor supported palliative care led to a significant strengthening of the general out-patient palliative care. The number of patients, integrated in our structures of palliative care in 2014 tripled compare to those of 2009/2010. Well trained and experienced coordinators are the essential guarantee of multidisciplinary and multiprofessional team-work. The results of the regional palliative care structures are different also after the agreement came in effect. Data for quality assurance should be periodically collected and evaluated in the future to develop the palliative care structures for outpatients.
自2009年起，根据在威斯特法伦-利珀地区为居家晚期患者提供姑息治疗的协议，家庭医生和姑息治疗医生在协调员的支持下展开合作。
自2009年起，对这种合作在供应结构、患者数量及其死亡地点方面进行评估。
在威斯特法伦-利珀地区，每年约有91000名患者死亡，其中约19%（即17699名患者）被纳入姑息治疗体系，相比2009/2010年的约6%有所增加。在最初几年，约70%的姑息治疗患者在家中死亡，到2014年这一比例增至75%。2014年只有9%的患者在医院（普通病房）死亡，而2009/2010年这一比例约为13%。这在城市和农村地区均适用。
以家庭医生为支持的居家姑息治疗理念显著加强了普通门诊姑息治疗。2014年纳入我们姑息治疗体系的患者数量相比2009/2010年增加了两倍。训练有素且经验丰富的协调员是多学科和多专业团队合作的重要保障。在协议生效后，地区姑息治疗体系的结果也存在差异。未来应定期收集和评估质量保证数据，以发展门诊姑息治疗体系。
