Academic Journal
Προβολή σε EDS

FuturePall: Forecasting the specialized inpatient palliative care in Germany based on demographic trends and utilization rates.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: FuturePall: Forecasting the specialized inpatient palliative care in Germany based on demographic trends and utilization rates.
Συγγραφείς: Kamp MA; Brandenburg Medical School Theodor Fontane, Faculty of Health Sciences Brandenburg and Immanuel Clinic, University Hospital of the Brandenburg Medical School Theodor Fontane, Rüdersdorf bei Berlin, Germany. marcelalexander.kamp@mhb-fontane.de., Bergmann J; trinovis GmbH, Hannover, Germany., von Saß C; Brandenburg Medical School Theodor Fontane, Faculty of Health Sciences Brandenburg and Immanuel Clinic, University Hospital of the Brandenburg Medical School Theodor Fontane, Rüdersdorf bei Berlin, Germany., Fink L; Brandenburg Medical School Theodor Fontane, Faculty of Health Sciences Brandenburg and Immanuel Clinic, University Hospital of the Brandenburg Medical School Theodor Fontane, Rüdersdorf bei Berlin, Germany., Adelstein J; trinovis GmbH, Hannover, Germany., Muehlensiepen F; Brandenburg Medical School Theodor Fontane, Faculty of Health Sciences Brandenburg and Immanuel Clinic, University Hospital of the Brandenburg Medical School Theodor Fontane, Rüdersdorf bei Berlin, Germany.; Center for Health Services Research Brandenburg, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany., van Oorschot B; Rangdorf bei, Berlin, Germany.
Πηγή: BMC palliative care [BMC Palliat Care] 2026 Jun 15; Vol. 25 (1). Date of Electronic Publication: 2026 Jun 15.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: BioMed Central Country of Publication: England NLM ID: 101088685 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-684X (Electronic) Linking ISSN: 1472684X NLM ISO Abbreviation: BMC Palliat Care Subsets: MEDLINE
Imprint Name(s): Original Publication: London : BioMed Central, [2002-
Ιατρικοί όροι (MeSH): Palliative Care*/trends , Palliative Care*/statistics & numerical data , Palliative Care*/methods , Demography*/trends, Forecasting/methods ; Inpatients/statistics & numerical data ; Germany ; Humans ; Female ; Aged ; Male ; Middle Aged ; Adult ; Aged, 80 and over
Περίληψη: Introduction: Demographic aging poses a significant challenge for specialized inpatient palliative care (SIPC). In the German healthcare system, SIPC is defined as hospital-based multi-professional care delivered through dedicated palliative units, consultation services, or complex care on general wards. To inform future resource allocation, this study predicts the demand for SIPC in Germany up to 2035, specifically examining the impact of shifting population structures on hospital-based palliative service utilization.
Methods: We analyzed baseline utilization data from the 2021 Trinovis Database, which aggregates mandatory structural and performance reports from German hospitals submitted to the Federal Joint Committee (G-BA). Specialized inpatient palliative care (SIPC) was defined using specific Operation and Procedure (OPS) codes. By applying these age-, gender-, and region-specific utilization rates to population projections provided by the German Federal Statistical Office, we forecasted the annual demand for SIPC from the 2021 baseline through the target year of 2035.
Results: Germany's adult population is expected to decline slightly by 2035, but the proportion of individuals aged 65 years and older will increase. SIPC cases are projected to rise from 108,645 in 2021 to 119,923 by 2035, reflecting a growth rate of 0.7% annually. The proportion of SIPC cases involving patients aged 65 years and older will increase. Regional disparities will persist, with varying growth rates in different federal states.
Conclusion: The "FuturePall" study forecasts a rising demand for SIPC in Germany due to demographic shifts, particularly among older adults. Policymakers must plan for these changes by allocating resources, enhancing infrastructure, and adapting healthcare strategies to meet the evolving needs of an aging population. Future research should explore the impact of non-demographic factors on SIPC demand.
(© 2026. The Author(s).)
Competing Interests: Declarations. Ethics approval and consent to participate: We exclusively relied on publicly available data, removing the need for individual patient con-sent. We followed the ethical principles outlined in the 1964 Helsinki Declaration and its later amendments, and all procedures involving human participants in this study were approved by the institutional and local ethics committee (study ID: 190032024-ANF, ethics committee of the Brandenburg Medical School, Germany). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
References: Saunders C. The care of the dying patient and his family. Doc Med Ethics 1975(5). https://doi.org/10.1080/13520806.1972.11759235 .
Ong CK, Forbes D. Embracing Cicely Saunders’s concept of total pain. BMJ. 2005;331(7516):576. (PMID: 10.1136/bmj.331.7516.576-d161507751200625)
Pace A, Dirven L, Koekkoek JAF, Golla H, Fleming J, Ruda R, Marosi C, Le Rhun E, Grant R, Oliver K, et al. European Association for Neuro-Oncology (EANO) guidelines for palliative care in adults with glioma. Lancet Oncol. 2017;18(6):e330–40. (PMID: 10.1016/S1470-2045(17)30345-528593859)
Ferrell BR, Temel JS, Temin S, Alesi ER, Balboni TA, Basch EM, Firn JI, Paice JA, Peppercorn JM, Phillips T, et al. Integration of Palliative Care Into Standard Oncology Care: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol. 2017;35(1):96–112. (PMID: 10.1200/JCO.2016.70.147428034065)
De Simone B, Chouillard E, Podda M, Pararas N, de Carvalho Duarte G, Fugazzola P, Birindelli A, Coccolini F, Polistena A, Sibilla MG, et al. The 2023 WSES guidelines on the management of trauma in elderly and frail patients. World J Emerg Surg. 2024;19(1):18. (PMID: 10.1186/s13017-024-00537-83881676611140935)
Michels G, John S, Janssens U, Raake P, Schutt KA, Bauersachs J, Barchfeld T, Schucher B, Delis S, Karpf-Wissel R et al. [Palliative aspects in clinical acute and emergency medicine as well as intensive care medicine: Consensus paper of the DGIIN, DGK, DGP, DGHO, DGfN, DGNI, DGG, DGAI, DGINA and DG Palliativmedizin]. Med Klin Intensivmed Notfmed 2023:1–25. https://doi.org/10.1007/s00063-023-01016-9 .
Palliativmedizin für Patienten mit einer nicht heilbaren Krebserkrankung. Kurzversion 2.3 [ https://www.leitlinienprogramm-onkologie.de/fileadmin/user_upload/Downloads/Leitlinien/Palliativmedizin/Version_2/LL_Palliativmedizin_Kurzversion_2.3.pdf ].
Onkologische. Qualitätsindikatoren - Leitlinienbasierte Qualitätsindikatoren im Leitlinienprogramm Onkologie (OL). Version 6.
Earle CC, Neville BA, Landrum MB, Souza JM, Weeks JC, Block SD, Grunfeld E, Ayanian JZ. Evaluating claims-based indicators of the intensity of end-of-life cancer care. Int J Qual Health Care. 2005;17(6):505–9. (PMID: 10.1093/intqhc/mzi06115985505)
Melching H. Neue gesetzliche Regelungen für die Palliativversorgung und ihre Implikationen für Politik und Praxis. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz. 2017;60(1):4–10. (PMID: 10.1007/s00103-016-2480-y27995269)
Kamp MA, Willert A-C, Dunkl V, Kowski AB, Golla H. Palliative Begleitung bei neuroonkologischen Erkrankungen: Schwerkranke Menschen in multidisziplinären Teams behandeln. DNP–Die Neurologie Psychiatrie. 2025;26(1):35–42. (PMID: 10.1007/s15202-025-6389-x)
Cremer-Schaeffer P, Radbruch L. [Palliative care in the light of legal and regulatory requirements in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2012;55(2):231–7. (PMID: 10.1007/s00103-011-1408-922290167)
Simon ST, Pralong A, Radbruch L, Bausewein C, Voltz R. The Palliative Care of Patients With Incurable Cancer. Dtsch Arztebl Int. 2020;116(7):108–15. (PMID: 321648237081049)
Berendt J, Brunner S, Heckel M, Tewes M, Ostgathe C, Gahr S. Symptom burden and relief in palliative care units of German Comprehensive Cancer Center and other hospitals. J Cancer Res Clin Oncol. 2024;150(3):160. (PMID: 10.1007/s00432-023-05557-63853212110965705)
Gahr S, Berendt J, Lodel S, Ostgathe C, Simon ST, Tewes M, Zader K, Schwartz J, Neukirchen M. [Palliative Care Teams in the German Comprehensive Cancer Centers]. Dtsch Med Wochenschr. 2019;144(23):e153–9. (PMID: 31454850)
Brunner S, Heckel M, Zenz D, Ostgathe C, Gahr S. [Health- and disease-related data of inpatients in palliative care units of the Comprehensive Cancer Centers and other hospitals in comparison-Data from the Hospice and Palliative Care Register]. Wien Med Wochenschr. 2022;172(7–8):172–80. (PMID: 10.1007/s10354-021-00910-135080683)
Sterbefälle L. [ https://www.destatis.de/DE/Themen/Gesellschaft-Umwelt/Bevoelkerung/Sterbefaelle-Lebenserwartung/_inhalt.html#234182].
Sulak H, Fiedler C, Klüsener S, Loichinger E, Spieß CK, Stawarz N, Weinmann M. Demografischen Wandel neu entdecken. Bundesinstitut für Bevölkerungsforschung; 2022. https://doi.org/10.12765/bro-2022-02.
Knecht S, Reiners H, Siebler M, Platz T, Floel A, Busse R. [Slow demographic change and neurological rehabilitation-Part 1: state of affairs]. Nervenarzt. 2023;94(8):708–17. (PMID: 10.1007/s00115-022-01415-x36534175)
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370(9596):1453–7. (PMID: 10.1016/S0140-6736(07)61602-X)
A changing population -. Assumptions and results of the 14th coordinated population projection [ https://www.destatis.de/EN/Themes/Society-Environment/Population/Population-Projection/Publications/Downloads-Population-Projection/germany-population-2060-5124206199004 .pdf?__blob=publicationFile&v=2].
Ditscheid B, Meissner F, Gebel C, Hennig B, Marschall U, Meissner W, Wedding U, Freytag A. Utilization of palliative care at the end of life in Germany: temporal trend (2016–2019) and regional variability. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2023;66(4):432–42. (PMID: 10.1007/s00103-023-03683-73689733210063517)
Freytag A, Meissner F, Krause M, Lehmann T, Jansky MK, Marschall U, Schmid A, Schneider N, Vollmar HC, Wedding U, et al. [A regional comparison of outcomes quality and costs of general and specialized palliative care in Germany: a claims data analysis]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2023;66(10):1135–45. (PMID: 10.1007/s00103-023-03746-93753508610539464)
vonSass C, Wedding U, Bergmann J, Fink L, Adelstein J, van Oorschot B, Muehlensiepen F, Kamp MA. [Impact of the hospital structural reform and socio-economic deprivation in North Rhine-Westphalia (NRW) on the accessibility of specialized inpatient palliative care]. Gesundheitswesen 2026;88(4):250–259. https://doi.org/10.1055/a-2633-5943 .
Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction. Med Care. 1981;19(2):127–40. (PMID: 10.1097/00005650-198102000-000017206846)
Rehner L, Moon K, Hoffmann W, van den Berg N. Specialised palliative care in nursing homes - Retrospective analysis on the basis of claims data. PLoS ONE. 2025;20(2):e0319001. https://doi.org/10.1371/journal.pone.0319001 . (PMID: 10.1371/journal.pone.03190013995147311828421)
Leiz M, Moon K, Rehner LK, Stentzel U, Radicke F, Hoffmann W, van den Berg N. Population-Based, Spatial Analysis of Specialised Ambulatory Palliative Care in Mecklenburg-Western Pomerania, Germany, on the Basis of Reimbursement Data. Int J Environ Res Public Health 2023;20(3):2231. https://doi.org/10.3390/ijerph20032231 .
Ditscheid B, Krause M, Lehmann T, Stichling K, Jansky M, Nauck F, Wedding U, Schneider W, Marschall U, Meissner W, et al. [Palliative care at the end of life in Germany: Utilization and regional distribution]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2020;63(12):1502–10. (PMID: 10.1007/s00103-020-03240-6331857107686196)
Gesell D, Hodiamont F, Bausewein C, Koller D. Accessibility to specialist palliative care services in Germany: a geographical network analysis. BMC Health Serv Res. 2023;23(1):786. (PMID: 10.1186/s12913-023-09751-73748857910364400)
Petzold T, Nauck F, Banse C, Augustin J, Jansky M. [Spatial access to palliative care units in Germany: integrated analysis of availability and accessibility using the E2SFCA method]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2025;68(10):1128–37. (PMID: 10.1007/s00103-025-04124-34090356012460442)
Prutz F, Sass AC. [Data on palliative care in Germany: Which data sources are available and what do they tell?]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2017;60(1):26–36. (PMID: 27966014)
Schwabe S, Buck C, Herbst FA, Schleef T, Stiel S, Schneider N. Status exploration and analysis of regional hospice and palliative care networks in Germany: A protocol for a mixed-methods study. PLoS ONE. 2023;18(6):e0286583. (PMID: 10.1371/journal.pone.02865833726727210237382)
Stiel S, van Baal K, Ulgut R, Stahmeyer JT, Schneider N. Analysing the administration of an intermediate level of outpatient palliative care in Germany and developing recommendations for improvement (Polite): A study protocol for a mixed-methods study. PLoS ONE. 2021;16(9):e0256467. (PMID: 10.1371/journal.pone.0256467344737308412349)
Kaasa S, Loge JH, Aapro M, Albreht T, Anderson R, Bruera E, Brunelli C, Caraceni A, Cervantes A, Currow DC, et al. Integration of oncology and palliative care: a Lancet Oncology Commission. Lancet Oncol. 2018;19(11):e588–653. (PMID: 10.1016/S1470-2045(18)30415-730344075)
Vanbutsele G, Pardon K, Van Belle S, Surmont V, De Laat M, Colman R, Eecloo K, Cocquyt V, Geboes K, Deliens L. Effect of early and systematic integration of palliative care in patients with advanced cancer: a randomised controlled trial. Lancet Oncol. 2018;19(3):394–404. (PMID: 10.1016/S1470-2045(18)30060-329402701)
Thamm C, Button E, Johal J, Knowles R, Gulyani A, Paterson C, Halpern MT, Charalambous A, Chan A, Aranda S, et al. A systematic review and meta-analysis of patient-relevant outcomes in comprehensive cancer centers versus noncomprehensive cancer centers. Cancer. 2025;131(1):e35646. (PMID: 10.1002/cncr.3564639565056)
Payne S, Chan N, Davies A, Poon E, Connor S, Goh C. Supportive, palliative, and end-of-life care for patients with cancer in Asia: resource-stratified guidelines from the Asian Oncology Summit 2012. Lancet Oncol. 2012;13(11):e492–500. (PMID: 10.1016/S1470-2045(12)70380-723117004)
Klinger CA, Howell D, Zakus D, Deber RB. Barriers and facilitators to care for the terminally ill: a cross-country case comparison study of Canada, England, Germany, and the United States. Palliat Med. 2014;28(2):111–20. (PMID: 10.1177/026921631349334223801462)
Kelley AS, Morrison RS. Palliative Care for the Seriously Ill. N Engl J Med. 2015;373(8):747–55. (PMID: 10.1056/NEJMra1404684262878504671283)
Dasch B, Lenz P. Der Sterbeort von Tumorpatienten im zeitlichen Trend. Der Onkologe. 2021;27(6):602–9. (PMID: 10.1007/s00761-021-00926-7)
Dorin L, Krupa E, Metzing S, Buscher A. Gender disparities in German home-care arrangements. Scand J Caring Sci. 2016;30(1):164–74. (PMID: 10.1111/scs.1223626036651)
Saeed F, Hoerger M, Norton SA, Guancial E, Epstein RM, Duberstein PR. Preference for Palliative Care in Cancer Patients: Are Men and Women Alike? J Pain Symptom Manage. 2018;56(1):1–6. e1. (PMID: 10.1016/j.jpainsymman.2018.03.014295810346015521)
Fink L, van Oorschot B, von Sass C, Dibue M, Foster MT, Golla H, Goldbrunner R, Senft C, Lawson McLean A, Hellmich M, et al. Palliative care for in-patient malignant glioma patients in Germany. J Neurooncol. 2024;167(2):323–38. (PMID: 10.1007/s11060-024-04611-83850696011023986)
Fink L, von Sass C, Golla H, Voltz R, Muehlensiepen F, Ploner CJ, Slotty P, van Oorschot B, Kowski AB, Kamp MA. Epidemiology and palliative care of in–patient cerebral metastases cases in Germany. J Neurooncol 2025;173(1):37–48. https://doi.org/10.1007/s11060-024-04928-4 .
Golinelli D, Sanmarchi F, Guarducci G, Palombarini J, Benetti P, Rosa S, Lenzi J. Gender differences in healthcare utilization across Europe: Evidence from the European Health Interview Survey. Health Policy. 2025;162:105448. (PMID: 10.1016/j.healthpol.2025.10544841022014)
Karagiannidis C, Krause F, Bentlage C, Wolff J, Bein T, Windisch W, Busse R. In-hospital mortality, comorbidities, and costs of one million mechanically ventilated patients in Germany: a nationwide observational study before, during, and after the COVID-19 pandemic. Lancet Reg Health - Europe 2024;42:100954. https://doi.org/10.1016/j.lanepe.2024.100954 .
Fries JF. Measuring and monitoring success in compressing morbidity. Ann Intern Med. 2003;139(5 Pt 2):455–9. (PMID: 10.7326/0003-4819-139-5_Part_2-200309021-0001512965976)
Fries JF. Chap. 19 - On the Compression of Morbidity: From 1980 to 2015 and Beyond. In: Handbook of the Biology of Aging (Eighth Edition). edn. Edited by Kaeberlein MR, Martin GM. San Diego: Academic Press; 2016:507–524. https://doi.org/10.1111/j.1468-0009.2005.00401.x .
Karagiannidis C, Haering A, Augurzky B, Busse R. Krankenhausreform: Noch zu wenig Schwerpunktbildung. Dtsch Arztebl. 2023;122:A–1823.
Contributed Indexing: Keywords: Demographic change; Future; Prediction; Specialized inpatient palliative care
Entry Date(s): Date Created: 20260614 Date Completed: 20260614 Latest Revision: 20260726
Update Code: 20260726
PubMed Central ID: PMC13267715
DOI: 10.1186/s12904-026-02130-z
PMID: 42289685
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1472-684X
DOI:10.1186/s12904-026-02130-z