Status, demand and practice models of palliative day-care clinics and day hospices: a scoping review

Abstract

BackgroundLittle is known about the structure, accessibility, service provision and needs of palliative and hospice day-care in Germany and abroad. Researchers, healthcare providers and policy makers would benefit from a systematic overview.AimThe aim was to identify, describe and summarise available evidence on status, demand and practice models of palliative day-care clinics and day hospices. A secondary aim was to disclose research gaps and present recommendations for clinical practice and future research.DesignThe scoping review followed the methodological framework of Arksey and O’Malley. The analysed publications included studies of varying kinds to describe the current state of the art.Data sourcesUsing a highly sensitive search strategy, the authors searched PubMed, Web of Science Core Collection, CINAHL and Google Scholar within the publication window of inception to 12 June 2020. An additional hand search of the reference lists of the identified review articles was conducted.ResultsThe authors screened the titles and abstracts of 2643 studies, retrieved 197 full texts and included 32 articles in the review. The review identified nine major themes: (1) the referral process, (2) models of care, (3) patient characteristics, (4) demand, (5) the discharge process, (6) perceptions of services, (7) funding and costs, (8) outcome measurement and (9) education.ConclusionsThere is a need for further research to identify groups of patients who would receive the most benefit from palliative and hospice day-care and to determine any necessary revisions in admission criteria.

DNVF-Memorandum Versorgungsforschung im letzten Lebensjahr

“…Außerdem wurde in der AAPV im Jahr 2017 die besonders qualifizierte und koordinierte palliativmedizinische Versorgung (BQKPMV) [63] eingeführt. Im letzten Lebensjahr erhielten diese Leistungen 24,4 % der im Jahr 2014 verstorbenen Patientinnen und Patienten [64]. Daraus lässt sich jedoch nicht unmittelbar schließen, wie viele Menschen tatsächlich palliativ versorgt werden, da z.…”

“…Daneben gibt es in Deutschland einige palliativmedizinische Tageskliniken und -hospize, die an eine Palliativstati-on oder ein Hospiz angegliedert sind. Aktuelle Forschung zu Tageshospizen beschäftigt sich vor allem mit der Erhebung des diesbezüglichen Bedarfs [65], bereits bestehender Strukturen [66] und ihrer Evaluation [64,67]. Schätzungen zum Bedarf an Palliativdiensten sowie an allgemeiner stationärer Palliativversorgung, Zahlen zu ihrer Inanspruchnahme und qualifizierten Leistungserbringern sind weitere wichtige Themen der Versorgungsforschung im letzten Lebensjahr.…”

Consensus-based recommendations for the development and expansion of palliative day care clinics in Germany: results of a Delphi study

“…Internationally, the goal of palliative day care clinics is to promote autonomy and improve quality of life for patients in need of palliative care, through medical care (e.g., ascites punctures, wound management), symptom control, physiotherapy, occupational therapy, art and music therapy, complementary therapies (e.g., aromatherapy, massage), and family caregiver support [4][5][6][7][8][9][10][11][12][13][14][15]. The German guidelines for palliative care for cancer patients refer to palliative day care (clinics) as a primarily medical model of care [16,17].…”

Scoping Reviews in der Palliativforschung

“…u.) [1] und den Einschluss von Literatur und Studien diverser Designs zielt, eignen sich Scoping Reviews insbesondere zur Erschließung noch junger Forschungsfelder wie dem der Palliativversorgung [2][3][4][5].…”