• Nils Schneider and Friedrich Wilhelm Schwartz.
• Medizinische Hochschule Hannover, Abteilung für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Carl-Neuberg-Strasse 1, 30627 Hannover. schneider.nils@mh-hannover.de
• Med Klin. 2006 Jul 15;101(7):552-7.

AbstractThe health care for patients with incurable, advanced diseases is increasingly attended to in Germany. Among other things, this is enforced by the debate on euthanasia and by the criticism of the inadequate structure of services and processes of care. The palliative care approach refers to cancer as well as to non-cancer patients; due to demographic changes, it becomes more and more important for an increasing number of old and very old patients with particular complex needs (e. g., caused by multimorbidity, dementia and chronic pain). Therefore, the need for improving palliative care is immense. However, the statements on the current situation and the recommendations for improvement are based only slightly on valid scientific data. This article (written from the perspective of health services research) provides an overview on the topic with particular respect to the structure of specialized palliative care services (such as palliative care teams and palliative care units) and to the political framework. Open questions on diverse levels are picked out as a central theme, and the need for interdisciplinary, application-oriented research is pointed out.

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