palliative patients
Conditions
Interventions
Group 1: Palliative patients with care in the palliative day clinic (at least 4 treatment days up to a maximum of 20 treatment days)
Group 2: Palliative patients without care in the palliative day cli
Sponsors
Alexianer St. Potsdam
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Eligibility for consent, insured with participating health insurance companies existing palliative care (AAPV, BQKPMV, SAPV) oncological diagnosis or decompensated heart failure NYHA 3-4 no planned or possible inpatient intervention/operation granting of informed written consent
Exclusion criteria
Exclusion criteria: lack of capacity to consent lack of German language skills Participation in other interventional studies inpatient palliative medical care invasive ventilation Degree of care >3 not living at home (no inpatient care facilities) only able to be transported lying down not giving written consent to participate in the study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The mean number of full inpatient hospital stays per time (here 1 year) between the 1st PallTK treatment day (T0) and the end of the treatment period (T2 = last treatment day/ 20th treatment day or end of the 18-month intervention period, whichever comes first) measured using health insurance data. | — |
Secondary
| Measure | Time frame |
|---|---|
| The mean duration of SAPV service receipt within a period of 3 months after the end of treatment within the PallTK (T2) will be compared between intervention group (IG) and control group (KG) measured using health insurance data. Symptom severity is measured using standardized questionnaires for patients in palliative care at T0, T1 (4th day of treatment) and T2 for patients in the IG. The values before (T0) and after the intervention (T1) and (T2) are compared. The accompanying health economic evaluation compares incremental costs between T0 and T2 measured using health insurance data and incremental effects in the intervention and matched control group (incremental cost-effectiveness ratio; ICER). The patients' health-related quality of life is assessed at T0, T1 and T2 (for >4 treatment days). The values of the IG before (T0) and after the intervention (latest of T1-T2) are compared. Whether patients of the IG have a health care proxy/ living will is surveyed at T0, T1 and T2 (for >4 treatment days). The proportion of patients with a health care proxy/living will before (T0) and after the intervention (latest of T1-T2) is compared. The burden on family caregivers is measured. Values before (T0) and after the intervention (T1/T2) are compared. Process evaluation: In addition to a participatory stakeholder workshop, qualitative semi-structured interviews with PallTK patients and relatives will be conducted across the sites to gain in-depth insights into individual needs and requirements for healthcare as well as their experiences of care through a PallTK and implementation factors. PallTK staff, general practitioners and specialists are interviewed to gain their perspectives. Mixed focus groups will be held to utilize group dynamic processes and strengthen the cooperation of the palliative care networks. In order to gain a deeper understanding of the impact, processes at individual case level are analyzed in contrast. Potential referr | — |
Countries
Germany
Contacts
Public ContactKatrin Ziemann
Alexianer St. Potsdam
Outcome results
None listed