Analyzing the use of specialized palliative care in intensive care unit patients in Germany: a cross-sectional study
Abstract Background Despite rising importance of integration of palliative medicine in treating life-threatening illnesses in intensive care units (ICU), the extent remains unknown. Using billing data, we analysed the frequency of specialized palliative care use in ICU patients in Germany. Methods B...
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BMC
2025-03-01
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| Series: | BMC Palliative Care |
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| Online Access: | https://doi.org/10.1186/s12904-025-01718-1 |
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| author | Christiane von Saß Theresa Tenge Birgitt van Oorschot Dawid Pieper Nicole Eisenmenger Martin Heinze Larissa Fink Guido Michels Martin Neukirchen Marcel A. Kamp |
| author_facet | Christiane von Saß Theresa Tenge Birgitt van Oorschot Dawid Pieper Nicole Eisenmenger Martin Heinze Larissa Fink Guido Michels Martin Neukirchen Marcel A. Kamp |
| author_sort | Christiane von Saß |
| collection | DOAJ |
| description | Abstract Background Despite rising importance of integration of palliative medicine in treating life-threatening illnesses in intensive care units (ICU), the extent remains unknown. Using billing data, we analysed the frequency of specialized palliative care use in ICU patients in Germany. Methods Billing data (2019 -2022) from the InEK was used in this cross-sectional study on all billed adult ICU cases. Data included case numbers, demographics, diagnoses, treatment procedures, ventilation (≥ 95 h), palliative care frequency. Results 61,591,299 adult cases were treated, 11.2% (6,912,316) requiring ICU and 499,262 (7.2%) needing long-term ventilation. 44.2% of all ICU cases and 36.2% of long-term ventilated patients were female (p < 0.0001). ICU mortality was 11.1%, long-term ventilation mortality was 38.8%; higher in men and patients aged ≥ 65 (p < 0.001). Leading diagnoses for ICU deaths: heart failure (6.9%), stroke (6.3%), sepsis (6.2%). 0.8% of ICU cases and 1.4% of long-term ventilated cases received specialized palliative care, with a higher proportion of females (p < 0.0001). Most palliative care patients were aged ≥ 65. Conclusion From 2019 to 2022, 11.2% of hospital cases required ICU-treatment. Despite suffering from life-threatening conditions and high mortality rates, less than 1% of all ICU cases and 1.4% of long-term ventilated cases received palliative care (differing sexes and ages). This highlights deficiencies in palliative care integration into ICUs to alleviate patients and their families suffering from complex needs. Implementing benchmarking could be beneficial in this process. |
| format | Article |
| id | doaj-art-6d7bbca811a640daa2a9dea00075fabb |
| institution | OA Journals |
| issn | 1472-684X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj-art-6d7bbca811a640daa2a9dea00075fabb2025-08-20T01:48:21ZengBMCBMC Palliative Care1472-684X2025-03-0124111810.1186/s12904-025-01718-1Analyzing the use of specialized palliative care in intensive care unit patients in Germany: a cross-sectional studyChristiane von Saß0Theresa Tenge1Birgitt van Oorschot2Dawid Pieper3Nicole Eisenmenger4Martin Heinze5Larissa Fink6Guido Michels7Martin Neukirchen8Marcel A. Kamp9Palliative Care, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences BrandenburgInterdisciplinary Centre for Palliative Care, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD)Interdisciplinary Center for Palliative Medicine, Clinic for Radiation Oncology, University Hospital WürzburgFaculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Institute for Health Services and Health System ResearchReimbursement InstituteCenter for Mental Health, Immanuel Clinic Rüdersdorf, University Hospital of Brandenburg Medical School Theodor FontanePalliative Care, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences BrandenburgDepartment of Emergency Medicine, Hospital of the Barmherzige BrüderInterdisciplinary Centre for Palliative Care, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD)Palliative Care, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences BrandenburgAbstract Background Despite rising importance of integration of palliative medicine in treating life-threatening illnesses in intensive care units (ICU), the extent remains unknown. Using billing data, we analysed the frequency of specialized palliative care use in ICU patients in Germany. Methods Billing data (2019 -2022) from the InEK was used in this cross-sectional study on all billed adult ICU cases. Data included case numbers, demographics, diagnoses, treatment procedures, ventilation (≥ 95 h), palliative care frequency. Results 61,591,299 adult cases were treated, 11.2% (6,912,316) requiring ICU and 499,262 (7.2%) needing long-term ventilation. 44.2% of all ICU cases and 36.2% of long-term ventilated patients were female (p < 0.0001). ICU mortality was 11.1%, long-term ventilation mortality was 38.8%; higher in men and patients aged ≥ 65 (p < 0.001). Leading diagnoses for ICU deaths: heart failure (6.9%), stroke (6.3%), sepsis (6.2%). 0.8% of ICU cases and 1.4% of long-term ventilated cases received specialized palliative care, with a higher proportion of females (p < 0.0001). Most palliative care patients were aged ≥ 65. Conclusion From 2019 to 2022, 11.2% of hospital cases required ICU-treatment. Despite suffering from life-threatening conditions and high mortality rates, less than 1% of all ICU cases and 1.4% of long-term ventilated cases received palliative care (differing sexes and ages). This highlights deficiencies in palliative care integration into ICUs to alleviate patients and their families suffering from complex needs. Implementing benchmarking could be beneficial in this process.https://doi.org/10.1186/s12904-025-01718-1Palliative medicineCritical careInterdisciplinary researchLong-term ventilationAgeGender |
| spellingShingle | Christiane von Saß Theresa Tenge Birgitt van Oorschot Dawid Pieper Nicole Eisenmenger Martin Heinze Larissa Fink Guido Michels Martin Neukirchen Marcel A. Kamp Analyzing the use of specialized palliative care in intensive care unit patients in Germany: a cross-sectional study BMC Palliative Care Palliative medicine Critical care Interdisciplinary research Long-term ventilation Age Gender |
| title | Analyzing the use of specialized palliative care in intensive care unit patients in Germany: a cross-sectional study |
| title_full | Analyzing the use of specialized palliative care in intensive care unit patients in Germany: a cross-sectional study |
| title_fullStr | Analyzing the use of specialized palliative care in intensive care unit patients in Germany: a cross-sectional study |
| title_full_unstemmed | Analyzing the use of specialized palliative care in intensive care unit patients in Germany: a cross-sectional study |
| title_short | Analyzing the use of specialized palliative care in intensive care unit patients in Germany: a cross-sectional study |
| title_sort | analyzing the use of specialized palliative care in intensive care unit patients in germany a cross sectional study |
| topic | Palliative medicine Critical care Interdisciplinary research Long-term ventilation Age Gender |
| url | https://doi.org/10.1186/s12904-025-01718-1 |
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