Study protocol for a multi-methods study: SAVOIR - evaluation of specialized outpatient palliative care (SAPV) in Germany: outcomes, interactions, regional differences

Abstract

BackgroundSince 2007, the German statutory health insurance covers Specialized Outpatient Palliative Care (SAPV). SAPV offers team-based home care for patients with advanced and progressive disease, complex symptoms and life expectancy limited to days, weeks or months. The introduction of SAPV is ruled by a directive (SAPV directive). Within this regulation, SAPV delivery models can and do differ regarding team structures, financing models, cooperation with other care professionals and processes of care. The research project SAVOIR is funded by G-BA’s German Innovations Fund to evaluate the implementation of the SAPV directive.MethodsThe processes, content and quality of SAPV will be evaluated from the perspectives of patients, SAPV teams, general practitioners and other care givers and payers. The influence of different contracts, team and network structures and regional and geographic settings on processes and results including patient-reported outcomes will be analyzed in five subprojects: [1] structural characteristics of SAPV and their impact on patient care, [2] quality of care from the perspective of patients, [3] quality of care from the perspective of SAPV teams, hospices, ambulatory nursing services, nursing homes and other care givers, content and extent of care from [4] the perspective of General Practitioners and [5] from the perspective of payers.The evaluation will be based on different types of data: team and organizational structures, treatment data based on routine documentation with electronic medical record systems, prospective assessment of patient-reported outcomes in a sample of SAPV teams, qualitative interviews with other stakeholders like nursing and hospice services, a survey in general practitioners and a retrospective analysis of claims data of all SAPV patients, covered by the health insurance fund BARMER in 2016.DiscussionData analysis will allow identification of variables, associated with quality of SAPV. Based on these findings, the SAVOIR study group will develop recommendations for the Federal Joint Committee for a revision of the SAPV directive.Trial registrationGerman Clinical Trials Register (DRKS): DRKS00013949 (retrospectively registered, 14.03.2018), DRKS00014726 (14.05.2018), DRKS00014730 (30.05.2018). Subproject 3 is an interview study with professional caregivers and therefore not registered in DRKS as a clinical study.

Is there an unmet medical need for palliative care services in Germany? Incidence, prevalence, and 1-year all-cause mortality of palliative care sensitive conditions: real-world evidence based on German claims data

“…The study at hand indicates a considerable demand for methodologically sound and well-arranged studies to quantify the Public Health burden of palliative conditions in Germany. Findings such as ours, together with an upcoming evaluation study on specific types of palliative care (Freytag et al 2019), should be taken into account in the context of health care planning.…”

Palliativversorgung am Lebensende in Deutschland

“…Als Teilprojekt des G‑BA-innovationsfondsgeförderten Projekts SAVOIR [ 11 ], FKZ 01VSF16005, führten wir eine retrospektive Kohortenstudie mit GKV-Abrechnungsdaten durch, die im wissenschaftlichen Datawarehouse der BARMER bereitgestellt wurden. Primäres Einschlusskriterium für die Studienpopulation war ein Todesdatum im Jahr 2016.…”

The Role of Outpatient Care Accreditation in Enhancing Foreign Patients’ Perception of Colombian Medical Tourism: A Quasi-experimental Design

“…The limited application of 1 variable negatively affects the perception of quality. [13][14][15][16] Various authors analyzed whether patients' perception of time quality is related to the duration of a consultation. 17 According to the authors, although participants were satisfied with the time spent with physicians (high valuation of the above first variable), they declared that physicians did not explain their health situation in "easy" way to understand, so it took more time than they would expect (low valuation of the third variable).…”