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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Palliative Care 1/2015

Comparison of terminally ill cancer- vs. non-cancer patients in specialized palliative home care in Germany – a single service analysis

Zeitschrift:
BMC Palliative Care > Ausgabe 1/2015
Autoren:
Stephanie Stiel, Maria Heckel, Andreas Seifert, Tobias Frauendorf, Roland Martin Hanke, Christoph Ostgathe
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

SS: Conception and design, Data analysis and data interpretation, drafting the manuscript. MH: Data analysis and interpretation, Manuscript writing. AS: Data analysis and interpretation. TF: Acquisition of data, Data analysis. RMH: Acquisition of data, Final approval of manuscript. CO: Conception and design, Data interpretation, drafting the manuscript or revising it critically for important intellectual content. All authors approved the final version of the manuscript for submission.

Abstract

Background

Palliative care (PC) is no longer offered with preference to cancer patients (CA), but also to patients with non-malignant, progressive diseases. Taking current death statistics into account, PC in Europe will face a growing number of patients dying from non-cancer diseases (NCA). More insights into specialized palliative home care (SPHC) in NCAs are needed.

Methods

Retrospective analysis and group comparisons between CAs and NCAs of anonymous data of all patients cared for between December 2009 and June 2012 by one SPHC team in Germany. Patient-, disease- and care-related data are documented in clinical routine by specialized PC physicians and nurses in the Information System Palliative Care 3.0 ® (ISPC®).

Results

Overall, 502 patients were cared for by the SPHC team; from 387 patients comprehensive data sets were documented. These 387 data sets (CA: N = 300, 77.5 % and NCA: N = 87, 22.5 %) are used for further analysis here. NCAs were significantly older (81 vs. 73 years; p < .001), than CAs and most often suffered from diseases of the nervous system (40 %). They needed significantly more assistance with defecation (87 vs. 74 %; p < .001) and urination (47 vs. 29 %; p < .001) and were more often affected from impaired vigilance (30 vs. 11 %; p < .001) than CAs. A by trend higher proportion of NCAs died within one day after admission to palliative home care (12 vs. 5 %; p < .05) and a smaller proportion was re-admitted to hospital during home care (6 vs. 20 %; p < .001). NCAs died predominantly in nursing homes (50 vs. 20 %; p < .001).

Conclusions

Although the proportion of NCAs was relatively high in this study, the access to PC services seems to takes place late in the disease trajectory, as demonstrated by the lower survival rate for NCAs. Nevertheless, the results show, that NCAs PC needs are as complex and intense as in CAs.
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