Inpatient Palliative Medicine - Medical Care Analysis of Oncological and Non-Oncological Patients of a University Hospital Palliative Care Unit

Background Management of palliative care patients suffering from complex acute symptoms is secured by inpatient palliative care units. The number of these distinctly increased in Germany within the last years. Facing the growing demand of palliative care beds and to secure optimal treatment an analysis of current structures is absolutely necessary. Using the data of a ten year existing university hospital palliative care unit this study aimed to examine patients' diagnoses, mortality rate, discharge destinations and length of stay on the ward. Furthermore it was taken out to investigate differences between oncological and non-oncological patients regarding their age and general health condition. Methods A retrospective epidemiological study using descriptive statistics was carried out to analyse diagnoses, mortality rate, discharge destinations and patients' length of stay on the ward who were treated from 2007 to 2016. Differences of oncological and non-oncological patients were examined in the years 2015 and 2016 by considering their age, Karnofsky performance scale index and Barthel index. Statistical significance was verified by using the unpaired t-test. Results Altogether 2360 patients were examined. 94% of these were admitted out of a tumour disease and 6% out of a non-tumour disease. Mortality rate of all patients was 55 %, but mortality rate of non-oncological patients was sharply higher than the one of oncological (73% vs. 54%). Non-oncological patients were 11.9 years older and presented themselves with a 13.2% lower Karnofsky performance scale index and a 23.4 points lower Barthel index at time of hospital admission. Discharging home was possible in 61% of the released patients, 23% were moved to a hospice. Average length of stay of all patients was 11 days. Conclusions Although an extraordinary high amount of patients suffering from a tumour disease were treated on the reported ward, an increase of palliative supply requirements for non-oncological patients is clearly identifiable. Non-oncological patients need a distinct more complex palliative care treatment compared to oncological ones as patients with no tumour disease get a later access to palliative care.