ArticleBMC palliative care2020
Quality indicators for the evaluation of end-of-life care in Germany - a retrospective cross-sectional analysis of statutory health insurance data.
Article in BMC palliative care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 38 citations in OpenAlex.
- Dyadic-concordance death-preparedness states and end-of-life care received by cancer patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Impact of outpatient palliative care on healthcare costs in Germany - an analysis of cancer and non-cancer patients based on health insurance data.Health economics review · 2025Article
- Experiences of intensive care unit nurses in end-of-life care at Ho Teaching Hospital, Ghana: a qualitative study.BMC nursing · 2025Article
- The instrumental value of advance directives: lesson learned from the COVID-19 pandemic for policymaking.Research in health services & regions · 2025Article
- Selecting indicators for the measurement of low-value care using German claims data: A three-round modified Delphi panel.PloS one · 2025Article
- The impact of specialized pediatric palliative care on advance care planning and healthcare utilization in children and young adults: a retrospective analysis of medical records of in-hospital deaths.BMC palliative care · 2024Article
- End-of-life care in Germany between 2016 and 2020 - A repeated cross-sectional analysis of statutory health insurance data.BMC palliative care · 2024Article
- A refined ICD-10 diagnoses-based approach for retrospective analysis of potential palliative care need and coverage in claims data of deceased.SAGE open medicine · 2024Article
- [A regional comparison of outcomes quality and costs of general and specialized palliative care in Germany: a claims data analysis].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2023Observational
- Factors associated with suffering from dying in patients with cancer: a cross-sectional analytical study among bereaved caregivers.BMC palliative care · 2023Article
- [Utilization of palliative care at the end of life in Germany: temporal trend (2016-2019) and regional variability].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2023Article
- Feasibility, use and benefits of patient-reported outcome measures in palliative care units: a multicentre observational study.BMC palliative care · 2023Observational
- Quality of end-of-life care in general practice - a pre-post comparison of a two-tiered intervention.BMC primary care · 2022Article
- Quality indicators of palliative care for cardiovascular intensive care.Journal of intensive care · 2022Review
- Improving primary palliative care - a Delphi consensus study on measures for general practice in Germany.BMC primary care · 2022Article
- [Healthcare expenditure and the impact of age: a detailed analysis for survivors and decedents].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2021Article
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe provision and quality of end-of-life care (EoLC) in Germany is inconsistent. Therefore, an evaluation of current EoLC based on quality indicators is needed. This study aims to evaluate EoLC in Germany on the basis of quality indicators pertaining to curative overtreatment, palliative undertreatment and delayed palliative care (PC). Results were compared with previous findings.
methodsData from a statutory health insurance provider (AOK Lower Saxony) pertaining to deceased members in the years 2016 and 2017 were used to evaluate EoLC. The main indicators were: chemotherapy for cancer patients in the last month of life, first-time percutaneous endoscopic gastrostomy (PEG) for patients with dementia in the last 3 months of life, number of hospitalisations and days spent in inpatient treatment in the last 6 months of life, and provision of generalist and specialist outpatient PC in the last year of life. Data were analysed descriptively.
resultsData for 64,275 deceased members (54.3% female; 35.1% cancer patients) were analysed. With respect to curative overtreatment, 10.4% of the deceased with cancer underwent chemotherapy in the last month and 0.9% with dementia had a new PEG insertion in the last 3 months of life. The mean number of hospitalisations and inpatient treatment days per deceased member was 1.6 and 16.5, respectively, in the last 6 months of life. Concerning palliative undertreatment, generalist outpatient PC was provided for 28.0% and specialist outpatient PC was provided for 9.0% of the deceased. Regarding indicators for delayed PC, the median onset of generalist and specialist outpatient PC was 47.0 and 24.0 days before death, respectively.
conclusionCompared to data from 2010 to 2014, the data analysed in the present study suggest an ongoing curative overtreatment in terms of chemotherapy and hospitalisation, a reduction in new PEG insertions and an increase in specialist PC. The number of patients receiving generalist PC remained low, with delayed onset. Greater awareness of generalist PC and the early integration of PC are recommended.
trial registrationThe study was registered in the German Clinical Trials Register ( DRKS00015108 ; 22 January 2019).
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