Wie unterscheiden sich Bedürfnisse und Versorgung in der SAPV in Abhängigkeit von der Grunderkrankung? Auswertungen aus dem Nationalen Hospiz- und Palliativregister

Zusammenfassung

Hintergrund Patienten mit nicht-malignen Grunderkrankungen gelten in den Strukturen der spezialisierten Palliativversorgung als unterrepräsentiert, und es steht zur Diskussion, welches Strukturformat am ehesten dem spezifischen Unterstützungsbedarf dieser Patienten entgegenkommt.

Methodik Wir analysierten daher 8078 (bzw. 6913 verwertbare) Datensätze aus den Jahren 2011–2018 aus dem Nationalen Hospiz- und Palliativregister von Patienten, die in der Spezialisierten Ambulanten Palliativversorgung mitbetreut wurden und differenzierten je nach Grunderkrankung. Die Auswertung erfolgte statistisch deskriptiv.

Ergebnisse Bei allen Gruppen von Grunderkrankungen zeigten sich ein vergleichbares Spektrum an physischen Symptomen und psychosozialen Belastungen, mit einigen (wenigen) grunderkrankungsspezifischen Differenzen sowie vergleichbaren Besserungen mancher Symptome innerhalb des Versorgungszeitraums. Bei der Dokumentation des Sterbeorts zeigte sich eine deutliche Dominanz onkologischer Patienten in Palliativstationen und Hospizen.

Diskussion Bei einem vielfach homogenen Bild zeigen sich nur wenige Differenzen zwischen dem Unterstützungsbedarf von Patienten mit nicht-malignen Grunderkrankungen im Vergleich zu Krebspatienten. Diese Befunde sollten dennoch bei der Ausgestaltung palliativmedizinischer Strukturen berücksichtigt werden.

Abstract

Background Patients with non-malignant diseases are considered to be underrepresented in specialized palliative care and it is under discussion which structural format is most likely to meet the specific needs of support of these patients.

Methods We therefore analyzed 8,078 (respectively 6,913 usable) data sets from 2011–2018 from the National Hospice and Palliative Care Registry, focusing on patients who were being treated in specialized palliative home care, and further classified depending on the underlying disease. Analysis was performed by using descriptive statistics.

Results A comparable range of physical and psychosocial symptoms was found in all subgroups, with only few disease-specific differences in symptoms and outcomes during the period of care. The explicit dominance of cancer patients in palliative care units and hospices was demonstrated by the documentation of the place of death.

Discussion While finding an overall homogeneous picture, there are some few disease-specific care patterns in palliative care. These findings should be taken into account when it comes to further conceptualisation of specialized palliative care structures.

Schlüsselwörter

Hospiz- und Palliativregister - nicht-maligne Grunderkrankungen - SAPV - Versorgungsqualität

Keywords

Hospice and Palliative Care Registry - non-malignant disease - specialized palliative home care - quality of care

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