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.
BMC Health Serv Res. 2023 Jul 24;23(1):786. doi: 10.1186/s12913-023-09751-7.
The 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.
Retrospective 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.
A 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.
A 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.
由于慢性病死亡人数增加和人口结构变化，未来几年对姑息治疗的需求将会增加。近年来，德国已经扩大了专科姑息治疗（SPC）的提供范围（姑息治疗病房（PCU）、专科姑息家庭护理（SPHC）团队和姑息治疗咨询（PCA）团队）。尽管可用性不断增加，但仍存在覆盖不足和长途旅行时间长的问题。目的是描述德国 SPC 服务的空间分布，计算设施的潜在可达性，并评估潜在的空间供应不足。
对德国 SPC 服务进行区域分析的回顾性横断面研究。在线注册的 SPC 服务地址进行地理编码，进行可达性和网络分析，并计算居住在 60 分钟车程内的人口比例。
共纳入 673 家机构。其分布不均匀，每四个区（110/401；27.4%）就有一个没有 SPC 服务。在德国一半的地区，现有的 PCU 和 SPHC 团队在 30 分钟内可以到达，近 90%的人口居住在那里。提供 PCA 团队的医院可以在 30 分钟内到达总面积的 17%，为 43%的人口提供服务。
SPHC 团队和 PCU 的高覆盖率表明德国的空间分布良好，但 SPC 服务的提供并不完全充足，特别是 PCA 团队。仍然需要进一步实施医院 PCA 团队。
