The Charateristics of Palliative Care in a Rural European Region

ABSTRACT The palliative care unit Landshut is one of the few centres accredited by the ESMO serving in a rural area (Lower Bavaria, Germany). It is part of the Network for Oncology and Palliative Care Medicine Landshut (Onkologisches und Palliativmedizinisches Netzwerk Landshut) which has been accredited 2010 by the ESMO as Designated Centre of Integrated Oncology and Palliative Care and the DGHO in 2011. The Network aims to improve the palliative care service with regard to the special needs of the rural cancer population. Data regarding palliative care of tumor patients in rural areas of Europe are lacking. In December 2010, a continuous data acquisition for patients on the palliative care unit located at the Hospital Landshut-Achdorf was started. We now present a cross sectional data analysis. Between December 2010 and March 2012, 499 patients were admitted for the first time to the palliative care unit. The majority of these patients were living outside the town boundaries, mainly in small villages. 84% of the patients were diagnosed with a solid tumour, 6% with a haematological malignancy, and 10% had a non-malignant disease. Before their first admission, 50% of the patients were treated with opioids, 44% of the patients had a central venous port system, 4% a gastric tube, and 10% had received parenteral nutrition. The most frequent symptoms leading to admission were reduced general health status (43%), uncontrolled pain (20%), dyspnoea (14%), nausea (8%), confusion (3%), and insufficient social support (3%). 48% of the patients died during the first admission. The mean time of hospitalization was 11 ± 7 days. After discharge from hospital, 37% were cared for by themselves or family members, 23% were visited by a community nurse or other nursing services, 19% were cared for by the outpatient palliative care program, 14% were admitted to a nursing home, 4% were transferred to another ward, and 3% to the hospice which had opened as recently as January 2012. Detailed data of the hospitalized palliative patients are presented and further discussed regarding the special needs of the growing rural palliative patient population. Disclosure All authors have declared no conflicts of interest.