Kosten und Erlöse der spezialisierten Palliativversorgung im ambulanten und stationären Bereich

Abstract

If the question of whether specialized palliative care pays off is understood in such way that the effort and costs are well proportioned to the benefits to those affected and to society, the answer to this question is clearly yes. The clear focus on the needs of those affected, which also includes relatives, and which often goes hand in hand with the omission of useless, unwanted, and often expensive diagnostic procedures and therapies, makes palliative care a highly economic form of care. In our healthcare system, which has been increasingly economized for decades, the question of whether something “pays off” is usually understood as whether the proceeds are favorable in relation to the costs by which profit can be made. However, especially in the German hospital system, it is easier to achieve surpluses with cost-intensive interventions than with a type of care in which the costs for staff account for the largest share. Therefore, the “problem” for business people is not that palliative medicine is too expensive, but rather that it is too cheap in certain areas. In general, no universal statement can be made about how lucrative specialized palliative care is. In particular, the outpatient and inpatient areas must be considered differently due to the different systems. Only in the case of multiprofessional palliative services in hospitals can it be stated that this increasingly important area is currently not regularly reimbursed to cover costs. On the other hand, palliative care units can be designed to cover costs and still ensure a high level of quality, especially if “secondary profits” are taken into account.