Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 20;24(1):74.
doi: 10.1186/s12904-025-01718-1.

Analyzing the use of specialized palliative care in intensive care unit patients in Germany: a cross-sectional study

Christiane von Saß  1 , Theresa Tenge  2   3 , Birgitt van Oorschot  4 , Dawid Pieper  5   6 , Nicole Eisenmenger  7 , Martin Heinze  8 , Larissa Fink  1 , Guido Michels  9 , Martin Neukirchen #  10   11 , Marcel A Kamp #  1   12
Affiliations

Analyzing the use of specialized palliative care in intensive care unit patients in Germany: a cross-sectional study

Christiane von Saß et al. BMC Palliat Care. .

Abstract

Background: Despite rising importance of integration of palliative medicine in treating life-threatening illnesses in intensive care units (ICU), the extent remains unknown. Using billing data, we analysed the frequency of specialized palliative care use in ICU patients in Germany.

Methods: Billing data (2019 -2022) from the InEK was used in this cross-sectional study on all billed adult ICU cases. Data included case numbers, demographics, diagnoses, treatment procedures, ventilation (≥ 95 h), palliative care frequency.

Results: 61,591,299 adult cases were treated, 11.2% (6,912,316) requiring ICU and 499,262 (7.2%) needing long-term ventilation. 44.2% of all ICU cases and 36.2% of long-term ventilated patients were female (p < 0.0001). ICU mortality was 11.1%, long-term ventilation mortality was 38.8%; higher in men and patients aged ≥ 65 (p < 0.001). Leading diagnoses for ICU deaths: heart failure (6.9%), stroke (6.3%), sepsis (6.2%). 0.8% of ICU cases and 1.4% of long-term ventilated cases received specialized palliative care, with a higher proportion of females (p < 0.0001). Most palliative care patients were aged ≥ 65.

Conclusion: From 2019 to 2022, 11.2% of hospital cases required ICU-treatment. Despite suffering from life-threatening conditions and high mortality rates, less than 1% of all ICU cases and 1.4% of long-term ventilated cases received palliative care (differing sexes and ages). This highlights deficiencies in palliative care integration into ICUs to alleviate patients and their families suffering from complex needs. Implementing benchmarking could be beneficial in this process.

Keywords: Age; Critical care; Gender; Interdisciplinary research; Long-term ventilation; Mortality; Palliative medicine.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: We exclusively relied on publicly available data, removing the need for individual patient consent. We followed the ethical principles outlined in the 1964 Helsinki Declaration and its later amendments, and all procedures involving human participants in this study were approved by the institutional and local ethics committee (study ID: 190032024-ANF, ethics committee of the Brandenburg Medical School, Germany). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Sex distribution. The figure illustrates the gender distribution in the analysed hospital case cohorts. Notably, the proportion of cases with female patients receiving palliative care was significantly higher. Once again, the proportion of cases with female patients in long-term ventilated cases receiving palliative care was significantly higher than in the comparison group. *Demonstrates a significant difference (P < 0.006)
Fig. 2
Fig. 2
Mortality
Fig. 3
Fig. 3
Infographic. Figure 3 summarizes the main results
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Neukirchen M, Metaxa V, Schaefer MS. Palliative care in intensive care. Intensive Care Med. 2023;49(12):1538–40. - PMC - PubMed
    1. Bogdanov C, Hohenstein S, Brederlau J, Groesdonk HV, Bollmann A, Kuhlen R. A comparison of different intensive care unit definitions derived from the German administrative data set: a methodological, real-world data analysis from 86 Helios hospitals. J Clin Med. 2024;13(12):3393. - PMC - PubMed
    1. Nelson JE, Meier DE, Litke A, Natale DA, Siegel RE, Morrison RS. The symptom burden of chronic critical illness. Crit Care Med. 2004;32(7):1527–34. - PubMed
    1. de Miranda S, Pochard F, Chaize M, Megarbane B, Cuvelier A, Bele N, Gonzalez-Bermejo J, Aboab J, Lautrette A, Lemiale V, et al. Postintensive care unit psychological burden in patients with chronic obstructive pulmonary disease and informal caregivers: A multicenter study. Crit Care Med. 2011;39(1):112–8. - PubMed
    1. Pochard F, Darmon M, Fassier T, Bollaert P-E, Cheval C, Coloigner M, Merouani A, Moulront S, Pigne E, Pingat J, et al. Symptoms of anxiety and depression in family members of intensive care unit patients before discharge or death. A prospective multicenter study. J Crit Care. 2005;20(1):90–6. - PubMed

LinkOut - more resources