TY - JOUR

T1 - Patients’ and Relatives’ Preferences for Outpatient and Day Care Services Within End-of-Life Care in Germany

T2 - A Discrete Choice Experiment

AU - Apolinarski, Beate

AU - Röwer, Hanna A.A.

AU - de Jong, Lea

AU - Herbst, Franziska A.

AU - Huperz, Carolin

AU - Schneider, Nils

AU - Damm, Kathrin

AU - Stiel, Stephanie

N1 - Funding Information: The present study comprised part of the study “ABPATITE – Improving health care for patients with terminal, progressive illnesses: Status and demand analysis for palliative day care clinics and day hospices and recommendations for health care planning”, financed by the German Innovation Fund of the Federal Joint Committee (Gemeinsamer Bundesausschuss) (Grant N° 01VSF19034). The funding body was not involved in the study design; the collection, analysis and interpretation of study data; or the drafting of this article.

PY - 2024/2/29

Y1 - 2024/2/29

N2 - Purpose: In Germany, patients with incurable chronic diseases living at home increasingly have the option of using outpatient and day care hospice and specialized palliative care services. The present study examined and compared patients’ and their relatives’ preferences for end-of-life outpatient and day care services. Patients and Methods: The study used a questionnaire integrating a discrete choice experiment. For six scenarios, participants chose between two hypothetical end-of-life care offers, described by seven attributes. The model compared place of care, frequency and duration of care and support, specialized medical palliative care, accompanied activities, and relieving patient counselling. The model also included optional overnight care and willingness to pay. Patients and the relatives of patients suffering from incurable, chronic diseases who were not yet receiving palliative care were recruited via hospitals and self-help groups (06/2021–07/2022). Results: The results were based on data from 436 questionnaires (patients: n=263, relatives: n=173). All attributes had a statistically significant impact on choice decisions, with place of care showing the greatest importance. All respondents highly preferred care in the patient’s home over out-of-home care. Patients stressed the importance of special medical (palliative) care and valued accompanied activities, often facilitated by hospice volunteers. Relatives, but not patients, considered the frequency and duration of care highly relevant. Conclusion: The results suggest a higher demand for care in the patient’s home than for out-of-home care. Patients’ and relatives’ high preference for special medical care and the relief of family caregiver burden should be considered in the design of day care services.

AB - Purpose: In Germany, patients with incurable chronic diseases living at home increasingly have the option of using outpatient and day care hospice and specialized palliative care services. The present study examined and compared patients’ and their relatives’ preferences for end-of-life outpatient and day care services. Patients and Methods: The study used a questionnaire integrating a discrete choice experiment. For six scenarios, participants chose between two hypothetical end-of-life care offers, described by seven attributes. The model compared place of care, frequency and duration of care and support, specialized medical palliative care, accompanied activities, and relieving patient counselling. The model also included optional overnight care and willingness to pay. Patients and the relatives of patients suffering from incurable, chronic diseases who were not yet receiving palliative care were recruited via hospitals and self-help groups (06/2021–07/2022). Results: The results were based on data from 436 questionnaires (patients: n=263, relatives: n=173). All attributes had a statistically significant impact on choice decisions, with place of care showing the greatest importance. All respondents highly preferred care in the patient’s home over out-of-home care. Patients stressed the importance of special medical (palliative) care and valued accompanied activities, often facilitated by hospice volunteers. Relatives, but not patients, considered the frequency and duration of care highly relevant. Conclusion: The results suggest a higher demand for care in the patient’s home than for out-of-home care. Patients’ and relatives’ high preference for special medical care and the relief of family caregiver burden should be considered in the design of day care services.

KW - ambulatory care

KW - discrete choice experiment

KW - hospice care

KW - medical day care

KW - palliative care

KW - preferences

UR - http://www.scopus.com/inward/record.url?scp=85186442386&partnerID=8YFLogxK

U2 - 10.2147/PPA.S442047

DO - 10.2147/PPA.S442047

M3 - Article

AN - SCOPUS:85186442386

VL - 18

SP - 519

EP - 529

JO - Patient preference and adherence

JF - Patient preference and adherence

SN - 1177-889X

ER -