The Palliative-Care-Teams in Mecklenburg-Vorpommern (M-V) a former demonstration project of the Medical Board M-V, were sponsored by the health insurance from 2001-2002 to improve outpatient palliative care in cooperation with general practitioners and nursing services.
Methods: Interventions: (1) Information was given to professionals, patients, and relatives about ambulatory palliative care. In quality circles GPs could share their experiences in palliative care. (2) Two Palliative Care Teams (one PCT=one physician and one nurse) cared for the in- and outpatients and supported the health care professionals in palliative care and cancer pain therapy (including quality-mangement, documentation and evaluation).
Results: (1) The PCTs cared for 255 patients to optimize palliative care and cancer pain treatment: Quality of live improved and the reduction in pain intensty was highly significant (pain scores fell from VAS 3.9 (median) at rest (and 6.4 under stress (e. g. movement or coughing)) to 2.7 (4.5) after the first contact with a PCT and dropped further to 2.3 (3.7) at the last visit before death. (2) Economic evaluations revealed that the employment of three Palliative-Care-Teams in a region of 250’000 to 300’000 inhabitants will save more then 280’000 Euros, if these PCTs care for 500 patients per year.
Conclusion: Mobile PCTs are able to improve outpatient palliative care and cancer pain therapy and avoid unnecessary admission to the hospitals. The economic evaluations showed, that more than 12% of the costs of treatment can be saved in advanced cancer patients by implementing full-time mobile PCTs in Germany. More mobile PCTs should be established to develop an ambulatory treatment that covers the whole area of one or more federal states of Germany and show the efficiency of this concept in a huge number of patients. Supported by federal ministry of health, grant: FB2-43332-50/12.