Outpatient palliative care during the COVID-19 pandemic: a retrospective single centre analysis in Germany
Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has challenged health care systems worldwide. In Germany, patients in a palliative care setting have the opportunity to receive treatment by a specialised mobile outpatient palliative care team (OPC). The given retrospective single...
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | BMC Palliative Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12904-022-01035-x |
| _version_ | 1811320701066412032 |
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| author | Jonas Behnke Philipp Friedrich Arndt Michael John Cekay Daniel Berthold Birgit Herentin Rio Dumitrascu Ulf Sibelius Bastian Eul |
| author_facet | Jonas Behnke Philipp Friedrich Arndt Michael John Cekay Daniel Berthold Birgit Herentin Rio Dumitrascu Ulf Sibelius Bastian Eul |
| author_sort | Jonas Behnke |
| collection | DOAJ |
| description | Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has challenged health care systems worldwide. In Germany, patients in a palliative care setting have the opportunity to receive treatment by a specialised mobile outpatient palliative care team (OPC). The given retrospective single centre analysis describes the use of OPC structures for terminally ill COVID-19 patients during the height of the pandemic in Germany and aims to characterise this exceptional OPC patient collective. Methods First, death certificates were analysed in order to collect data about the place of death of all deceased COVID-19 patients (n = 471) within our local governance district. Second, we investigated whether advance care planning structures were established in local nursing homes (n = 30) during the height of the COVID-19 pandemic in 2020. Third, we examined patient characteristics of COVID-19 negative (n = 1579) and COVID-19 positive (n = 28) patients treated by our tertiary care centre guided OPC service. Results The analysis of death certificates in our local district revealed that only 2.1% of all deceased COVID-19 patients had succumbed at their home address (n = 10/471). In contrast, 34.0% of COVID-19 patients died in nursing homes (n = 160/471), whereas 63.5% died in an inpatient hospital setting (n = 299/471). A large proportion of these hospitalised patients died on non-intensive care unit wards (38.8%). Approximately 33.0% of surveyed nursing homes had a palliative care council service and 40.0% of them offered advance care planning (ACP) structures for their nursing home residents. In our two OPC collectives we observed significant differences concerning clinical characteristics such as the Index of Eastern Cooperative Oncology Group [ECOG] (p = 0.014), oncologic comorbidity (p = 0.004), as well as referrer and primary patient location (p = 0.001, p = 0.033). Conclusions Most COVID-19 patients in our governance district died in an inpatient setting. However, the highest number of COVID-19 patients in our governance district who died in an outpatient setting passed away in nursing homes where palliative care structures should be further expanded. COVID-19 patients who died under the care of our OPC service had considerably fewer oncologic comorbidities. Finally, to relieve conventional health care structures, we propose the expansion of established OPC structures for treating terminally ill COVID-19 patients. |
| first_indexed | 2024-04-13T13:03:58Z |
| format | Article |
| id | doaj.art-3f12338eecd347efbdc7cc348617a1cf |
| institution | Directory Open Access Journal |
| issn | 1472-684X |
| language | English |
| last_indexed | 2024-04-13T13:03:58Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj.art-3f12338eecd347efbdc7cc348617a1cf2022-12-22T02:45:51ZengBMCBMC Palliative Care1472-684X2022-08-012111710.1186/s12904-022-01035-xOutpatient palliative care during the COVID-19 pandemic: a retrospective single centre analysis in GermanyJonas Behnke0Philipp Friedrich Arndt1Michael John Cekay2Daniel Berthold3Birgit Herentin4Rio Dumitrascu5Ulf Sibelius6Bastian Eul7Department of Internal Medicine IV, Justus-Liebig-University, Universities of Giessen and Marburg Lung Centre (UGMLC)Department of Internal Medicine IV, Justus-Liebig-University, Universities of Giessen and Marburg Lung Centre (UGMLC)Department of Internal Medicine IV, Justus-Liebig-University, Universities of Giessen and Marburg Lung Centre (UGMLC)Department of Internal Medicine IV, Justus-Liebig-University, Universities of Giessen and Marburg Lung Centre (UGMLC)Department of Internal Medicine IV, Justus-Liebig-University, Universities of Giessen and Marburg Lung Centre (UGMLC)Department of Internal Medicine IV, Justus-Liebig-University, Universities of Giessen and Marburg Lung Centre (UGMLC)Department of Internal Medicine IV, Justus-Liebig-University, Universities of Giessen and Marburg Lung Centre (UGMLC)Department of Internal Medicine IV, Justus-Liebig-University, Universities of Giessen and Marburg Lung Centre (UGMLC)Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has challenged health care systems worldwide. In Germany, patients in a palliative care setting have the opportunity to receive treatment by a specialised mobile outpatient palliative care team (OPC). The given retrospective single centre analysis describes the use of OPC structures for terminally ill COVID-19 patients during the height of the pandemic in Germany and aims to characterise this exceptional OPC patient collective. Methods First, death certificates were analysed in order to collect data about the place of death of all deceased COVID-19 patients (n = 471) within our local governance district. Second, we investigated whether advance care planning structures were established in local nursing homes (n = 30) during the height of the COVID-19 pandemic in 2020. Third, we examined patient characteristics of COVID-19 negative (n = 1579) and COVID-19 positive (n = 28) patients treated by our tertiary care centre guided OPC service. Results The analysis of death certificates in our local district revealed that only 2.1% of all deceased COVID-19 patients had succumbed at their home address (n = 10/471). In contrast, 34.0% of COVID-19 patients died in nursing homes (n = 160/471), whereas 63.5% died in an inpatient hospital setting (n = 299/471). A large proportion of these hospitalised patients died on non-intensive care unit wards (38.8%). Approximately 33.0% of surveyed nursing homes had a palliative care council service and 40.0% of them offered advance care planning (ACP) structures for their nursing home residents. In our two OPC collectives we observed significant differences concerning clinical characteristics such as the Index of Eastern Cooperative Oncology Group [ECOG] (p = 0.014), oncologic comorbidity (p = 0.004), as well as referrer and primary patient location (p = 0.001, p = 0.033). Conclusions Most COVID-19 patients in our governance district died in an inpatient setting. However, the highest number of COVID-19 patients in our governance district who died in an outpatient setting passed away in nursing homes where palliative care structures should be further expanded. COVID-19 patients who died under the care of our OPC service had considerably fewer oncologic comorbidities. Finally, to relieve conventional health care structures, we propose the expansion of established OPC structures for treating terminally ill COVID-19 patients.https://doi.org/10.1186/s12904-022-01035-xCOVID-19Outpatient palliative care (OPC)Advanced care planning (ACP)Cancer |
| spellingShingle | Jonas Behnke Philipp Friedrich Arndt Michael John Cekay Daniel Berthold Birgit Herentin Rio Dumitrascu Ulf Sibelius Bastian Eul Outpatient palliative care during the COVID-19 pandemic: a retrospective single centre analysis in Germany BMC Palliative Care COVID-19 Outpatient palliative care (OPC) Advanced care planning (ACP) Cancer |
| title | Outpatient palliative care during the COVID-19 pandemic: a retrospective single centre analysis in Germany |
| title_full | Outpatient palliative care during the COVID-19 pandemic: a retrospective single centre analysis in Germany |
| title_fullStr | Outpatient palliative care during the COVID-19 pandemic: a retrospective single centre analysis in Germany |
| title_full_unstemmed | Outpatient palliative care during the COVID-19 pandemic: a retrospective single centre analysis in Germany |
| title_short | Outpatient palliative care during the COVID-19 pandemic: a retrospective single centre analysis in Germany |
| title_sort | outpatient palliative care during the covid 19 pandemic a retrospective single centre analysis in germany |
| topic | COVID-19 Outpatient palliative care (OPC) Advanced care planning (ACP) Cancer |
| url | https://doi.org/10.1186/s12904-022-01035-x |
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