GPs’ involvement in specialised palliative home care: A mixed methods study in Germany

Figures & data

Figure 1. Categories of the focus group.

Table 1. Sociodemographics of participants.

	Focus group N	Postal survey N (%)
Numbers of participating GPs	6	445**
Gender
Male	6	217 (48.8%)
Female	–	226 (50.8%)
Missing values	–	2 (0.5%)
Age in years (Mean, age range)	57 (minimum: 52; maximum: 62)	53.5 (minimum: 33; maximum: 78)
Highest PC qualification
None	2	198 (44.7%)
3 months’ work experience in an inpatient PC facility	–	21 (4.7%)
Basic PC qualification*	1	162 (36.6%)
BQKPMV*	–	10 (2.3%)
Advanced PC qualification*	3	52 (11.3%)
Working experience in years (Mean)	27	18.1
Practice owner	6	364 (83.1%)

*Basic PC qualification: 40 h PC training course (PC basic course).

BQKPMV: qualification in ‘specially qualified coordinated palliative medical care’.

Advanced PC qualification: being a PC specialist with 120 h PC training course (qualified PC physician).

**In analysis, 18 GPs were excluded due to currently working in a specialised PHC team.

Figure 2. Domains of the survey.

Table 2. Factors correlating with the desire for general practitioners’ involvement in specialised palliative home care (linear regressions).

		After specialised palliative home care referral I would like to…
		Stay informed about patients’ care Coefficient (p-value)	Stay involved in patients’ care Coefficient (p-value)	Provide medical services myself Coefficient (p-value)
Qualification	None (reference)
	3 months work experience in an inpatient palliative care facilities	−0.035	0.010	0.209
		(0.838)	(0.574)	(0.293)
	Basic palliative care qualification°	0.026	0.063	0.144
		(0.748)	(0.461)	(0.136)
	Specially qualified coordinated palliative medical care (BQKPMV)°	0.098	−0.016	−0.151
		(0.671)	(0.948)	(0.575)
	Advanced palliative care qualification °	0.147	0.025	0.170
		(0.276)	(0.856)	(0.279)
Satisfaction with the cooperation with specialised palliative home care teams [18]		−0.054	−0.073	−0.181
		(0.276)	(0.162)	(0.002)
‘Palliative care is general practitioners’ duty’		0.108	0.445	0.388
		(0.145)	(0.000)	(0.000)
Gender (male (reference))		0.021	0.103	0.040
		(0.776)	(0.188)	(0.650)
Work experience in years		0.004	0.002	0.006
		(0.379)	(0.660)	(0.223)
Working as an employee (no (reference))		0.066	0.113	−0.010
		(0.545)	(0.321)	(0.936)
Constant		2.962	1.467	1.695
		(0.000)	(0.000)	(0.000)
N		382	380	377
Missing values		39	38	40
R^2		0.020	0.112	0.117

Legend.

Basic PC qualification: 40 h palliative care training course (palliative care basic course).

BQKPMV: is a qualification in ‘specially qualified coordinated palliative medical care’.

Advanced PC qualification: being a palliative care specialist with 120 h palliative care training course (qualified palliative care physician).

Table 3. General practitioners’ satisfaction with specialised palliative home care teams (linear regression).

General practitioners’ satisfaction with specialised palliative home care teams		Coefficient	Standard error	p-value	95% confidence interval
(Un)matching desired and realised involvement in specialised palliative home care	Unmatching – involvement less than desired (reference)
	Unmatching – involvement beyond desire	0.490	0.184	0.008	0.128	0.853
	Matching	0.514	0.075	0.000	0.366	0.661
Qualification	None (reference)
	3 months of work in an inpatient palliative care facility	−0.405	0.179	0.024	−0.756	−0.053
	Basic palliative care qualification^a	−0.178	0.083	0.033	−0.341	−0.015
	Specially qualified coordinated palliative medical care (BQKPMV)^a	−0.472	0.245	0.055	−0.955	0.011
	Advanced palliative care qualification^a	−0.186	0.132	0.160	−0.446	0.074
‘Palliative care is general practitioners’ duty’		0.041	0.079	0.602	−0.114	0.196
Work experience		−0.010	0.004	0.025	−0.018	−0.001
Gender		0.061	0.075	0.420	−0.087	0.209
Being an employee (no (reference))		0.035	0.117	0.767	−0.196	0.266
Constant		3.30	0.361	0.000	2.587	4.008
N = 346; R²=0.173; own calculations.

^aBasic PC qualification: 40h palliative care training course (palliative care basic course); BQKPMV: is a qualification in ‘specially qualified coordinated palliative medical care’; Advanced PC qualification: being a palliative care specialist with 120h palliative care training course (qualified palliative care physician).

Figure 3. GPs’ desired involvement in specialised PHC patient’s care.

Figure 4. GPs’ satisfaction as an specialised PHC referrer (oriented on KEF-CH [18]).

Table

(1)	Describe the justification for using a mixed methods approach to the research question – see study design
(2)	Describe the design in terms of the purpose, priority and sequence of methods – see study design
(3)	Describe each method in terms of sampling, data collection and analysis – see data collection
(4)	Describe where integration has occurred, how it has occurred and who has participated in it – see data collection & results
(5)	Describe any limitation of one method associated with the present of the other method – see discussion, strengths and limitations
(6)	Describe any insights gained from mixing or integrating methods – see discussion, main findings

Pfaff H, Diener S, Jung J. Die Zuweiserbefragung (KEF-CH) – Belegarztversion (KEF-CH-B): Kennzahlenhandbuch. Institut für Organisationsdiagnostik und Sozialforschung (IfOS) in Kooperation mit Verein Outcome; n.d.

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