[Palliative approach in outpatient care in Westphalia-Lippe--Follow-up study five years after inception of a structured home-based palliative care system].

INTRODUCTION: Since 2009, based on an agreement to implement palliative care for terminally ill patients at home in Westfalia-Lippe, family doctors and palliative doctors cooperate, supported by coordinators.
METHOD: Since 2009, this cooperation is evaluated, concerning supply structure, number of patients and their places of death.
RESULTS: In Westfalia-Lippe, yearly approx. 91.000 patients die, approx. 19 % of them, 17.699 patients, were included in palliative care structures, compared to some 6 % in 2009/2010. Whereas in the first years about 70 % of the palliative patients died at home, 2014 this number increased to 75 %. Only 9 % of our patients 2014 died in a hospital (normal ward) - compared to about 13 % in 2009/2010. This applies both for urban and rural areas.
CONCLUSIONS: The idea of home based, family doctor supported palliative care led to a significant strengthening of the general out-patient palliative care. The number of patients, integrated in our structures of palliative care in 2014 tripled compare to those of 2009/2010. Well trained and experienced coordinators are the essential guarantee of multidisciplinary and multiprofessional team-work. The results of the regional palliative care structures are different also after the agreement came in effect. Data for quality assurance should be periodically collected and evaluated in the future to develop the palliative care structures for outpatients. © Georg Thieme Verlag KG Stuttgart · New York.