Identification of regional hospice and palliative care networks in Germany – Results of a multi-method survey

Introduction: In the course of the implementation of the German Healthcare Development Act [Gesundheitsversorgungsweiterentwicklungsgesetz] of 2021, a funding structure according to sect. 39d of the Social Code Book V [SGB V] was established to promote regional hospice and palliative care networks (RHPN). The funded networks are expected to support the multiprofessional cooperation of hospice and palliative care providers at the structural level. It is still unclear how many existing and newly established network structures are eligible for funding according to sect. 39d SGB V and where these network structures are located regionally. The proportion of actually funded networks is also unknown. Methods: Between January and March 2023, network structures of hospice and palliative care were identified in a tripartite, multi-method survey procedure, consisting of a) research of databases, literature, and internet; b) open quantitative online-survey via SoSciSurvey software, and c) telephone survey of federal offices of health insurers. The data were first documented separately. Then, the research and survey data were combined and analysed via descriptive statistics using SPSS. Results: Based on the aggregated data from the literature-, database- and internet research and the online survey, n = 308 network structures of hospice and palliative care could be identified, of which n = 37 have applied for network funding according to sect. 39d SGB V. In the survey period, n = 47 applications for network funding according to sect. 39d SGB V were submitted to the health insurance funds. There is a high density of network structures in the northern, southern and western federal states, while there are only a few networks in the eastern states. According to the online-survey, 56 % (n = 136) of all the identified network structures with known sponsorship are organised by providers of specialised outpatient palliative care. 47 % (n = 29) of the networks with funding interest are organised as independent structures. Of the network structures with known funding status, 18 % (n = 26) plan to apply for funding according to sect. 39d SGB V in 2024 for the first time. Discussion: There are numerous network structures in hospice and palliative care, but they are differently distributed among the German federal states. The multi-method survey was able to provide a first nation-wide inventory of network structures as well as an assessment of networks with funding interest according to sect. 39 SGB V. A clear distinction between general network structures and structural networks according to sect. 39d SGB V is a challenge. In the next years the number of funding applications is expected to rise. Conclusion: The identification of existing and funded network structures of hospice and palliative care in Germany can be a starting point for a deeper analysis of the structure and the activities of the networks. A quality assessment tool that takes into account both the heterogeneity of the networks and the different dimensions of networking would be helpful.