Patients potentially in need for palliative care in Germany-A regional small-area estimation based on death registry data.

Background: Demographic change and the increasing prevalence of chronic illnesses lead to a higher demand for palliative care. Currently, little is known about potential need for palliative care at a small-area level in Germany. However, this is crucial for the planning of services. We aimed to calculate the proportion of the population potentially in need of palliative care on a small-area level and to illustrate the nationwide variations.

Methods: Retrospective cross-sectional study based on causes of death statistics in Germany. Causes of death of all adult deceased in Germany in 2022 were included. The potential need for palliative care was identified based on Murtagh et al. (2014) using ICD-10-codes. Geographic variation was analyzed on district level.

Results: 1,062,452 persons were documented in the causes of death statistics, of which 752,643 died with a potential palliative care need (70.8%). Overall mean age was 79.5 years (SD 12.7), 50.1% were female (n = 532,248). Most deaths were due to neoplasms (23,675; 22.6%) and cardiovascular diseases (230,338, 21.7%). The numbers of deceased with potential need per 100,000 inhabitants varied between districts from 578 to 1,438, with highest values in districts in Saxony, Thuringia, Saxony-Anhalt, and lowest in Bavaria and Baden-Wuerttemberg.

Discussion: Our definition of potential palliative care need included both deaths due to oncological diseases, who commonly receive palliative care, and non-oncological conditions. The findings highlight the regional differences in potential palliative care need on small-area level and the importance of comprehensive healthcare planning adapted to the specific needs of individuals.