Ambulante und stationäre palliativmedizinische Patientenversorgung in Deutschland

Abstract

The coverage of SPCS and in-hospital palliative care is still a theoretical construct in many regions of Germany. The number of existing SPCS teams and in-patient palliative institutions is insufficient to guarantee an exhaustive coverage of patient care as in emergency medical services. In order to achieve a higher quality of results the quality of the structure and processes must first be ensured. The distribution of palliative care should be centrally coordinated along the same lines as the emergency institutions in order to achieve a need-oriented exhaustive coverage. A surplus of care in some regions at the expense of an undersupply in other regions must be avoided. In the next step a further development and adaption of existing structures to the requirements would be a logical approach.

International recommendations for outpatient palliative care and prehospital palliative emergencies – a prospective questionnaire-based investigation

“…“Specialised Palliative Care Services” (SPCS) are an important element in the treatment of outpatient palliative emergencies [1-3]. A legal basis for receiving outpatient palliative care is outlined in the recommendation 24 of the Committee of Ministers to the European member states on the organisation of palliative care (adopted by the Committee of Ministers on 12 November 2003 at the 86 th meeting of the Minister Deputies Council of Europe): “Specialized palliative care should be available for all patients when they need it, at any time and in any situation”.…”

“…Patients in a palliative care setting and their care-giving relatives define good symptom control and security [for example, by access to 24-hour outpatient medical palliative care teams (PCTs)] and nursing care as major issues in outpatient palliative care [2,5,6]. Therefore, adequate SPCS should offer a patient satisfaction and safety in a home-based care environment [1,2,5]. Furthermore, through SPCS, the provision of adequate symptom control reduces a patients’ anxiety in emergency situations [8,10].…”

“…Therefore, outpatient PCTs are only partially guaranteed. For this type of care, other medical care systems are accessed for emergency medical treatment (3-10% of all prehospital emergencies are defined as palliative emergencies) of out-of-hospital palliative care emergencies (for example, prehospital emergency medical systems (EMS); paramedics and/or prehospital emergency physicians) [1,13-17]. This suggests that, theoretically, every prehospital emergency physician (EP), paramedic, and in-hospital emergency physician (ED) may be confronted by patients in a palliative care situation at an advanced stage of their disease who need medical care.…”

Specialized Home Palliative Care for Adults and Children: Differences and Similarities

“…A few studies stated the effectiveness of SHPC for adults and children to date, [14][15][16] but little data are available on the specific needs of adult and pediatric palliative care patients and the differences between these patient groups. To our knowledge, this is the first survey comparing SHPC for children and adults at the same center, prospectively and in parallel.…”

Vorbeugendes Krisenmanagement in der allgemeinen ambulanten Palliativversorgung

“…Beide Instrumente erfüllen somit bestimmte Funktionen (z.B. Sicherung der Patientenautonomie, Sicherung der Versorgung in Akutsituationen, Anordnungsfunktion, Therapieorientierung) [22,29]. Insbesondere bei Fehlen einer SAPV Unterstützung sollte die Erstellung einer Patientenverfügung/eines Notfallbogens Teil der AAPV sein [6,19].…”