Abstract
BackgroundTo date, there has been no systematic research on the intermediate level service (level 2) in outpatient palliative care that was introduced in Germany in 2017. Accordingly, the Polite research project aims at: (1) investigating the current state of level 2 palliative care and (2) developing recommendations for its optimisation.MethodsThe multi-perspective, observational study will follow a mixed-methods approach across two study phases. In phase 1a, quantitative routinely collected data from a statutory general local health insurance provider will be used to identify patients who received level 2 or other outpatient palliative care in the years 2017–2019. In phase 1b, a questionnaire will be sent to all registered general practitioners (GPs) in Lower Saxony to collect information on the number and characteristics of physicians offering level 2 palliative care. In phase 1c, a quantitative, standardised online questionnaire for teams providing specialised outpatient palliative care will be administered to assess the interfaces of level 2 palliative care. In phase 2a, the results from phases 1a–c will be discussed in an expert workshop with the aim of developing ideas to adapt and optimise level 2 outpatient palliative care. Finally, in phase 2b, the empirically derived recommendations from phases 1 and 2a will be agreed upon via a multi-round Delphi survey involving experts with sufficient influence to promote the project results and recommendations nationally.DiscussionThe results of the project will facilitate the optimisation of outpatient palliative care, as well as its administration, nationwide.Trial registrationThe study was registered in the German Clinical Trials Register (Deutsches Register Klinischer Studien) (Registration N° DRKS00024785); date of registration: 06th May 2021) and is searchable under the International Clinical Trials Registry Platform Search Portal of the World Health Organization, under the German Clinical Trials Register number.
Highlights
According to sociodemographic trends, it is estimated that at least 23.3% of German residents will be over 67 years old in 2030 [1]
In phase 1b, a questionnaire will be sent to all registered general practitioners (GPs) in Lower Saxony to collect information on the number and characteristics of physicians offering level 2 palliative care
There are several reasons to predict the successful application of the various work packages: 1) participation will require only a single or a few short (Delphi survey) expenditures of time; 2) the target populations are not difficult to reach; 3) the target number of participants was calculated in accordance with the topics and research methods applied in the respective study phases; and 4) recruitment will take place throughout Lower Saxony in phase 1 and Germany in phase 2
Summary
It is estimated that at least 23.3% of German residents will be over 67 years old in 2030 [1]. The absolute number of German residents over the age of 80 years is expected to increase from 4.4 million in 2013 to more than 9 million in 2060 [1]; this projected figure corresponds to approximately 12–13% of future population estimates. Approximately 80–90% of people requiring palliative care can be adequately cared for through generalist outpatient palliative care (level 1) [2]. Palliative care offerings in Germany have recently expanded and the number of service providers has increased, there is still a great need for palliative care, especially in rural areas [4]. The Polite research project aims at: (1) investigating the current state of level 2 palliative care and (2) developing recommendations for its optimisation
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