Structural characteristics and contractual terms of specialist palliative homecare in Germany

Jansky, Maximiliane; Heyl, Lia; Hach, Michaela; Kranz, Steven; Lehmann, Thomas; Freytag, Antje; Wedding, Ulrich; Meißner, Winfried; Krauss, Sabine H.; Schneider, Werner; Nauck, Friedemann

doi:10.1186/s12904-023-01274-6

BMC Palliative Care

Table 1 Characteristics of model contracts

From: Structural characteristics and contractual terms of specialist palliative homecare in Germany

	Version	Contract partners	Staff requirements	Mandatory cooperation	24-h service
Bavaria [19]	09/2010	HIF^a, SP^b	Four permanent posts; qualifications as defined by directive^d	Not specified	Physician
Baden-Württemberg [20]	01/2010	HIF^a, SP^b	Qualifications as defined by directive; newly established teams may employ staff for three years while they are in training	Not specified	Nurse and physician
Berlin, physicians [21]	12/2016	AIHP^c, Home Care Society, Nursing Association, HIF^a	Qualifications as defined by directive	Specialist mobile palliative care nursing service	Physician
Berlin, nursing care [21]	12/2016	AIHP^c, Home Care Society, nursing association, HIF^a	Team manager and three full-time nurses; qualifications as defined by directive	Specialist palliative care physician	Nurse
Brandenburg [22]	04/2009	HIF^a, SP^b	Physicians, nurses, coordinating nurse; physician qualification: advanced training in palliative medicine, (coordinating) nurse: qualifications as defined by directive	Not specified	Nurse or physician
Bremen [23]	08/2009	HIF^a, SP^b	Three physicians, four nurses; qualifications as defined by directive	Not specified	Nurse and physician
Hamburg [24]	02/2010	HIF^a, SP^b	Three physicians, four nurses; qualifications as defined by directive Four FTE nurses from a nursing service; at least two full-time nurses	Pharmacy	Nurse and physician
Hesse^e [25]	05/2009	HIF^a, SP^b	Qualifications as defined by directive. Possibility to employ staff while they are in training	Not specified	Nurse and physician
Hesse AOK health insurance fund	Not available
Mecklenburg-Western Pomerania [26]	unclear	HIF^a, SP^b	Qualifications as defined by directive	Not specified	Nurse or physician
Lower Saxony [27]	01/2010	HIF^a, SP^b	Qualifications as defined by directive, cooperating physicians: basic training	Pharmacy	Nurse or physician
North Rhine [28]	06/2009	HIF^a, AHIP^c	Three physicians, four nurses. Qualifications as defined by directive; exclusive or main activity in SPHC	Pharmacy	Nurse and physician
Rhineland Palatinate [29]	Contract was canceled at time of assessment
Saarland	Contract not publicly available
Saxony Anhalt [30]	03/2010	AHIP^c, SP^b	Not available
Saxony/Thuringia [31]		HIF^a, SP^b	At least five physicians with activity emphasis in palliative medicine, two of whom work at least 19 h/week exclusively in SPHC Four FTE nurses employed by SPHC team; at least two full-time nurses; the other FTE can be split, with each working at least 19h/week Qualifications as defined by directive	Palliative care unit	Nurse and physician
Schleswig–Holstein [32]	2009	HIF^a, SP^b	Qualifications as defined by directive		Nurse or physician
Westphalia [33]	04/2009	AHIP^c, SP^b	At least three physicians; at least one coordinating nurse; qualifications as defined by directive	General and specialist ambulatory physicians	Physician

^aHIF Health insurance fund; ^bSP service provider (SPHC team); ^cAHIP Association of Statutory Health Insurance Physicians;^d the SHPC directive demands that physicians have certified training in palliative medicine and have cared for at least 75 palliative care patients during the previous three years. Nurses must have certified training in palliative care and at least two years of practical experience of caring for palliative patients for at least six months in a specialised facility. All other professionals in the team should have the respective training in palliative care or practical experience with palliative care patients.^e Hesse has three model contracts for different groups of health insurance funds, which differ only in their reimbursement schemes; therefore, they have been combined in this table

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ISSN: 1472-684X

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