title: Comparison of terminally ill cancer- vs. non-cancer patients in specialized palliative home care in Germany - a single service analysis.
abstract: BACKGROUND
  Palliative care (PC) is no longer offered with preference to cancer patients (CA), but also to patients with non-malignant, progressive diseases. Taking current death statistics into account, PC in Europe will face a growing number of patients dying from non-cancer diseases (NCA). More insights into specialized palliative home care (SPHC) in NCAs are needed.
  
  
  METHODS
  Retrospective analysis and group comparisons between CAs and NCAs of anonymous data of all patients cared for between December 2009 and June 2012 by one SPHC team in Germany. Patient-, disease- and care-related data are documented in clinical routine by specialized PC physicians and nurses in the Information System Palliative Care 3.0 ® (ISPC®).
  
  
  RESULTS
  Overall, 502 patients were cared for by the SPHC team; from 387 patients comprehensive data sets were documented. These 387 data sets (CA: N = 300, 77.5 % and NCA: N = 87, 22.5 %) are used for further analysis here. NCAs were significantly older (81 vs. 73 years; p < .001), than CAs and most often suffered from diseases of the nervous system (40 %). They needed significantly more assistance with defecation (87 vs. 74 %; p < .001) and urination (47 vs. 29 %; p < .001) and were more often affected from impaired vigilance (30 vs. 11 %; p < .001) than CAs. A by trend higher proportion of NCAs died within one day after admission to palliative home care (12 vs. 5 %; p < .05) and a smaller proportion was re-admitted to hospital during home care (6 vs. 20 %; p < .001). NCAs died predominantly in nursing homes (50 vs. 20 %; p < .001).
  
  
  CONCLUSIONS
  Although the proportion of NCAs was relatively high in this study, the access to PC services seems to takes place late in the disease trajectory, as demonstrated by the lower survival rate for NCAs. Nevertheless, the results show, that NCAs PC needs are as complex and intense as in CAs.
authors.affiliation: Department of Palliative Medicine, Comprehensive Cancer Center CCC Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstraße 12, 91054, Erlangen, Germany. stephanie.stiel@uk-erlangen.de.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Stiel
authors.affiliation: Department of Palliative Medicine, Comprehensive Cancer Center CCC Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstraße 12, 91054, Erlangen, Germany. maria.heckel@uk-erlangen.de.
authors.forename: Maria
authors.initials: M
authors.lastname: Heckel
authors.affiliation: Innovation Incubator, Leuphana University of Lüneburg, Lüneburg, Germany. andreas.seifert@inkubator.leuphana.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Seifert
authors.affiliation: Department of Palliative Medicine, Comprehensive Cancer Center CCC Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstraße 12, 91054, Erlangen, Germany. tobi.frauendorf@gmx.de.
authors.forename: Tobias
authors.initials: T
authors.lastname: Frauendorf
authors.affiliation: Palliative Care Team (PCT) Team, Fürth, Germany. hanke@pct-fuerth.de.
authors.forename: Roland Martin
authors.initials: RM
authors.lastname: Hanke
authors.affiliation: Department of Palliative Medicine, Comprehensive Cancer Center CCC Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstraße 12, 91054, Erlangen, Germany. christoph.ostgathe@uk-erlangen.de.
authors.forename: Christoph
authors.initials: C
authors.lastname: Ostgathe
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005858:Germany; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D010166:Palliative Care / Q000706:statistics & numerical data*; D012111:Residence Characteristics; D012189:Retrospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors; D019452:Terminally Ill / Q000706:statistics & numerical data*