GPs’ involvement in specialised palliative home care: A mixed methods study in Germany

Abstract

Background General practitioners (GPs) are important providers of palliative home care (PHC). To deliver adequate palliative care, cooperation with specialised PHC teams is necessary. Specialised PHC is a type of care for severely ill patients by specialised providers. Little is known about the involvement of German GPs in specialised PHC. Objectives To analyse GPs’ experience with realised and desired involvement in specialised PHC. Realised involvement means GPs took part in specialised PHC patients’ care. Desired involvement is GPs’ hoped-for cooperation with specialised PHC teams: GPs could state whether they want to stay involved, be informed, or provide medical services themselves after referral to specialised PHC. Methods Mixed methods design (focus group with 6 GPs; survey of 445 GPs in North Rhine, Germany, about their experiences in PHC/specialised PHC): Qualitative data was interpreted using content analysis. The authors developed a questionnaire and performed descriptive analysis based on qualitative results. Results GPs are mostly satisfied with specialised PHC teams’ care, although they report cooperation is not always optimal. GPs describe a high satisfaction with quality of care by specialised PHC teams. However, physicians with higher PC knowledge are less satisfied with specialised PHC. Also, GPs are often less involved in specialised PHC than they wish, especially when they have a higher PC qualification. Conclusion In general, GPs are satisfied with the quality of care provided by specialised PHC teams but GPs do not always perceive cooperation as optimal. Involvement of GPs in specialised PHC needs to be improved.

Responsabilité médicale primaire auprès des malades graves

“…Un exemple provenant de la Westphalie-Lippe montre que cela est possible grâce à la création d'une association coopérative et que les MF de la région se sentent plus fortement responsables de la prise en charge des patientes et patients en soins palliatifs par rapport aux autres états fédéraux [16]. Un meilleur savoirfaire en soins palliatifs a également pour conséquence que les MF souhaitent être plus étroitement intégrés dans les traitements palliatifs [17].…”

Primäre ärztliche Verantwortung bei Schwerkranken

“…Ein Bei spiel aus WestfahlenLippe zeigt, dass dies durch die Gründung eines Kooperations vereins gelingt und sich die HA der Region im Vergleich zu anderen Bundesländern stärker verantwortlich für die Versorgung palliativer Patientinnen und Patienten fühlen[16]. Auch das bessere Knowhow in Pallia tive Care führt dazu, dass HA enger in palliative Behandlungen integriert sein wol len[17].LimitationenDie Formulare zur Klärung der PÄZ wurden im Beobachtungszeitraum nur bei 28% der Pa tientinnen und Patienten ihren betreuenden HA zugestellt. Dies ist auf die knappen perso nellen Ressourcen in unserem Team aber nicht auf weitere spezifische Kriterien zurückzufüh ren.…”