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

A Discrete Choice Experiment

authored by: Beate Apolinarski, Hanna A.A. Röwer, Lea de Jong, Franziska A. Herbst, Carolin Huperz, Nils Schneider, Kathrin Damm, Stephanie Stiel
Abstract: 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.
Organisation(s): Center for Health Economics Research Hannover (CHERH)
External Organisation(s): Hannover Medical School (MHH)
Bielefeld University of Applied Sciences
Type: Article
Journal: Patient preference and adherence
Volume: 18
Pages: 519-529
No. of pages: 11
ISSN: 1177-889X
Publication date: 29.02.2024
Publication status: Published
Peer reviewed: Yes
ASJC Scopus subject areas: Medicine (miscellaneous), Social Sciences (miscellaneous), Pharmacology, Toxicology and Pharmaceutics (miscellaneous), Health Policy
Sustainable Development Goals: SDG 3 - Good Health and Well-being
Electronic version(s): https://doi.org/10.2147/PPA.S442047 (Access: Open)