Table 1 Two kinds of palliative homecare in Germany

PPC

➣ Palliative homecare is mostly delivered as primary palliative care (PPC) [1]).

➣ PPC provided by General Practitioners (GPs) is often supported by nursing care services, ambulatory hospice services, etc.

➣ About 90% of patients at end of life can be sufficiently cared for with PPC, according to estimations of the German Association of Palliative Medicine [2].

SPHC

➣ Specialised palliative homecare (SPHC) for patients with severe, advanced, life-limiting illnesses and complex symptoms is funded by the Social Health Insurance.

➣is provided by multi-professional teams (physicians, nurses, other professionals), delivering specialised palliative care at patients’ homes/ nursing homes etc. [3].

➣ comprises care which in kind, severity and complexity can only be delivered by physicians with extra palliative qualifications, as well as 24-h availability.

➣ requires a referral from GPs, primary care specialists or upon discharge from hospital.

➣ main indications are complex, pronounced symptoms such as neurological, psychiatric or psychological, respiratory or cardiac symptoms, ulcerating wounds or tumours.