Palliative cancer care: an epidemiologic study.
OBJECTIVE
To analyze the need for palliative care in hospital patients who have cancer. Palliative care is an essential component of comprehensive cancer care and identification of palliative care needs (PCNs) of patients with cancer is a topic that has not been thoroughly studied.


METHODS
Data were collected prospectively from inpatients of University Medical Center Freiburg in Freiburg, Germany, with 982 hospital beds included in the study. During the observation period of 17 months, each patient discharged from a hospital ward was screened by surveying the treating physician who was responsible for dismissal about patients' PCNs based on the WHO 1990 definition of palliative care. To complete obligatory electronic discharge management, a modified dismissal form asking to classify the patient as having PCN "yes/no" had to be filled out for each patient discharged.


RESULTS
The response rate was 96% with data for 39,849 patients that could be analyzed. A total of 6.9% of all hospital patients and 9.1% of patients older than age 65 years were considered to have PCNs. Of the 2,757 patients with PCNs, 67% (n = 1,836) had cancer. Among the 11,584 patients with cancer, 15.8% were classified as having PCNs. PCNs were particularly high in patients with head and neck cancer (28.3%), malignant melanoma (26.0%), and brain tumors (18.2%). Suffering from cancer increases the probability of developing PCNs by a factor of 3.63 (95% CI, 3.27 to 4.04). For patients with metastatic cancer, the risk of developing PCNs is increased 12-fold (odds ratio, 12.27; 95% CI, 11.07 to 13.60).


CONCLUSIONS
Structures to provide palliative care for patients with cancer are needed.
Department of Palliative Care, University Medical Center Freiburg, Hugstetter Str 55, D-79106 Freiburg, Germany. gerhild.becker@uniklinik-freiburg.de
Gerhild
G
Becker
Isaak
I
Hatami
Carola
C
Xander
Bettina
B
Dworschak-Flach
Manfred
M
Olschewski
Felix
F
Momm
Peter
P
Deibert
Irene J
IJ
Higginson
Hubert E
HE
Blum
D000368:Aged; D005260:Female; D005858:Germany; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D010166:Palliative Care / Q000706:statistics & numerical data*