Spezialisierte Ambulante Palliativversorgung im städtischen Ballungsraum – Erfahrungen der ersten 6 Monate

[Characteristics of Care and Outcome Quality within the Specialized Ambulatory Palliative Care (SAPV): Analysis of Patient Characteristics and Indicators of Care of a Palliative Care Team]

BACKGROUND

The ambulatory specialized palliative care (SAPV) was implemented to enable patients with the need for end-of-life intensive care to die with accompanied professionality and in familiar surroundings. Studies on changes of patient characteristics as well as the contents of care within time are scarce. The aim of this study was the evaluation of care parameters and variations in time as well as a qualitative assessment of the dying process and the stress on the dependents.

METHODS

Anonymized routine patient data sets from 2012 to 2016 were retrospectively analyzed and compared to assess the efforts, characteristics of care as well as development of work within time. On the basis of the palliative care problem severity score (PCPSS), we developed the instrument "score of concern" to describe the quality of the dying process and the burden on the dependents.

RESULTS

In the complete time frame, 1806 cases were treated. The median age was 74 years, 82% had cancer, 36% were counselled, 14% had consultation, 50% had partial care. 98% died at their desired place. The patients of 2016 were older in comparison to those from 2012, had more non-oncological diagnoses, were more severely ill, were infrequently hospitalized and more intensely cared for. The dying process was associated with fewer signs of stress.

CONCLUSION

Data relevant for care document the changes in complexity as well as density of the work within time. The instrument "score of concern", developed to describe the dying process, can be a helpful tool to assess the qualitative outcome of patient and dependents' care and may be helpful also for other SAPV teams.