Table of Contents
International Journal of Palliative Care
Volume 2016 (2016), Article ID 2032071, 8 pages
http://dx.doi.org/10.1155/2016/2032071
Research Article

Individually Tailored Palliative Care in a Rural Region: A Representative Chart Survey and Physicians’ Experiences with Integrated Care

Institute for General Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany

Received 19 September 2015; Revised 13 March 2016; Accepted 31 March 2016

Academic Editor: Moira O’Connor

Copyright © 2016 André Terhorst et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Dying at home represents a special challenge in rural areas. This representative study describes the palliative care for patients in a rural German region. Methods. In a cross-sectional, representative study all physicians of a large rural area were surveyed in terms of their palliative care for a biennial period. In prestructured interviews and chart reviews physicians, practices, and palliative care patients’ characteristics were obtained. The data were matched with regional mortality data. Results. According to public data 463 inhabitants died during the biennial period: 248 patients (53.6%) died outside the region’s borders including all in-hospital patients, while 215 died within this territory (46.4%). Of the latter, a total of 91 patients (42.3%) received care by the 14 physicians surveyed (on average: 6.6 patients per physician). 89% of families were actively involved in care, especially in multigenerational family scenarios. If family members were not involved, nursing services were active instead. Significant predictors for dying at home were the wish to die at home, a cancer diagnosis, and having family support. Conclusions. This study shows a physician-based, individually tailored, rural palliative care approach which allowed the majority of patients to die at home. Families were documented as an important social resource.