Blaschke Katja, Hermes-Moll Kerstin, Lappe Veronika, Ihle Peter, Baumann Walter, Schubert Ingrid
PMV forschungsgruppe an der Medizinischen Fakultät und Uniklinik Köln, Universität zu Köln, Köln.
Wissenschaftliches Institut der Niedergelassenen Hämatologen und Onkologen, (WINHO GmbH), Köln.
Gesundheitswesen. 2020 Sep;82(8-09):702-709. doi: 10.1055/a-0829-6604. Epub 2019 Apr 11.
Palliative care patients frequently suffer from cancer diagnoses. Specialised palliative home care (German acronym 'SAPV') enables patients with complex symptoms and intensive care needs to receive home care until death. In the German Federal State of Hesse, the first SAPV teams were set up in 2009. Against this background, the aim of this study was (i) to investigate the utilization of SAPV and specialised inpatient palliative care in the last year of life of cancer patients, (ii) to detect the medical professions prescribing SAPV and (iii) to analyse the place of death and the hospitalization rate in the last 91 days of life.
A retrospective secondary data analysis was conducted. Routine data from the statutory health insurance company AOK Hesse in Germany for 2009-2014 were analysed using descriptive statistical methods. The study population comprised breast, prostate, and colorectal cancer patients who died in the year of observation (2010-2014) and who were fully insured 360 days before death.
Depending on the year of observation, 492-545 breast, 546-625 prostate, and 709-752 colorectal cancer patients were included in the study. The analysis showed an increase of cancer patients receiving palliative care from 2010 to 2014. A higher proportion of breast, prostate, and colorectal cancer patients received SAPV as compared to services from palliative care units or inpatient hospices. All in all, over 90% of the SAPV prescriptions were issued by family doctors. The hospitalization rate of cancer patients in the last 91 days of life as well as the share of those dying in hospital decreased between 2010 and 2014.
The results must be assessed in the context of the implementation of SAPV in the state of Hesse. The increase of SAPV services and the reduction of hospitalizations at the end of life indicate a successful introduction of SAPV in the state of Hesse.
姑息治疗患者经常被诊断患有癌症。专业姑息家庭护理（德语缩写为“SAPV”）使有复杂症状和重症护理需求的患者能够在家中接受护理直至去世。在德国黑森州，首批SAPV团队于2009年成立。在此背景下，本研究的目的是：（i）调查癌症患者生命最后一年中SAPV和专业住院姑息治疗的使用情况；（ii）确定开具SAPV处方的医疗职业；（iii）分析死亡地点以及生命最后91天的住院率。
进行了一项回顾性二次数据分析。使用描述性统计方法分析了德国法定健康保险公司黑森州AOK 2009 - 2014年的常规数据。研究人群包括在观察年（2010 - 2014年）去世且在去世前360天享有全额保险的乳腺癌、前列腺癌和结直肠癌患者。
根据观察年份，研究纳入了492 - 545例乳腺癌患者、546 - 625例前列腺癌患者和709 - 752例结直肠癌患者。分析表明，2010年至2014年接受姑息治疗的癌症患者有所增加。与姑息治疗病房或住院临终关怀服务相比，乳腺癌、前列腺癌和结直肠癌患者接受SAPV的比例更高。总体而言，超过90%的SAPV处方由家庭医生开具。2010年至2014年期间，癌症患者生命最后91天的住院率以及在医院死亡的比例有所下降。
必须在黑森州实施SAPV的背景下评估这些结果。SAPV服务的增加以及生命末期住院率的降低表明SAPV在黑森州的引入是成功的。
