Structural characteristics and contractual terms of specialist palliative homecare in Germany
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Le résumé fourni par la source
BACKGROUND: Multi-professional specialist palliative homecare (SPHC) teams care for palliative patients with complex symptoms. In Germany, the SPHC directive regulates care provision, but model contracts for each federal state are heterogeneous regarding staff requirements, cooperation with other healthcare providers, and financial reimbursement. The structural characteristics of SPHC teams also vary. AIM: We provide a structured overview of the existing model contracts, as well as a nationwide assessment of SPHC teams and their structural characteristics. Furthermore, we explore whether these characteristics serve to find specifc patterns of SPHC team models, based on empirical data. METHODS: This study is part of the multi-methods research project "SAVOIR", funded by the German Innovations Fund. Most model contracts are publicly available. Structural characteristics (e.g. number, professions, and affiliations of team members, and external cooperation) were assessed via an online database ("Wegweiser Hospiz- und Palliativversorgung") based on voluntary information obtained from SPHC teams. All the data were updated by phone during the assessment process. Data were descriptively analysed regarding staff, cooperation requirements, and reimbursement schemes, while latent class analysis (LCA) was used to identify structural team models. RESULTS: Model contracts have heterogeneous contract partners and terms related to staff requirements (number and qualifications) and cooperation with other services. Fourteen reimbursement schemes were available, all combining different payment models. Of the 283 SPHC teams, 196 provided structural characteristics. Teams reported between one and 298 members (mean: 30.3, median: 18), mainly nurses and physicians, while 37.8% had a psychosocial professional as a team member. Most teams were composed of nurses and physicians employed in different settings; for example, staff was employed by the team, in private practices/nursing services, or in hospitals. Latent class analysis identified four structural team models, based on the team size, team members' affiliation, and care organisation. CONCLUSION: Both the contractual terms and teams' structural characteristics vary substantially, and this must be considered when analysing patient data from SPHC. The identified patterns of team models can form a starting point from which to analyse different forms of care provision and their impact on care quality.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Structural characteristics and contractual terms of specialist palliative homecare in Germany
- Date Crossref
- 31/10/2023
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Göttingen pays non établi dans la noticeUniversité ou école supérieure
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Arbeitsgemeinschaft Mauerziegel pays non établi dans la noticeInstitution
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Jena University Hospital Center for Clinical Studies pays non établi dans la noticeÉtablissement de santé
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LMU Klinikum pays non établi dans la noticeÉtablissement de santé
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University of Augsburg Center for Interdisciplinary Health Research pays non établi dans la noticeUniversité ou école supérieure
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BARMER GEK pays non établi dans la noticeÉtablissement de santé
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University Medical Center Department of Palliative Medicine pays non établi dans la noticeUniversité ou école supérieure
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German Association for Palliative Medicine (DGP) pays non établi dans la noticeOrganisation à but non lucratif
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Bundesarbeitsgemeinschaft SAPV (BAG) pays non établi dans la noticeInstitution
University of Göttingen, Arbeitsgemeinschaft Mauerziegel et Center for Clinical Studies — Jena University Hospital, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.