Strukturelle voraussetzungen anästhesiologisch betreuter intensivstationen in Deutschland bezüglich entscheidungen zu end-of-life-care

Background: Structural aspects regarding end-of-life care (EOLC) in German intensive care units ICUs managed by anaesthesiologists are not well known. A survey was conducted to explore the status quo of structural aspects relevant for EOLC. Methods: In October 2015, all department heads who were members of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI) or the Association of German Anaesthesiologists (BDA) were asked to participate in an online survey about structural aspects relevant for EOLC. Data were collected regarding hospital category, type and level of care, providers, institution, numbers of ICU and IMC beds, treated patients per year, physician-patient and nurse-patient ratios, numbers of physicians and nurses specialized in palliative care, availability of spiritual and psychological support. Results: Out of 870 respondents, 122 returned full data sets (14%). Healthcare personnel staffing on ICUs was not completely according to current recommendations in Germany. Only few physicians and nurses were educated in palliative care. Palliative care nurses were found more frequently (9%) in hospitals pertaining to church or common welfare organisations than in other institutions (2-4%). Pastoral care was available in nearly all hospitals. In two-Thirds of all cases, a department or consultant for palliative care and/ or a psychologist was available at least during regular work hours, both most frequently in university hospitals (89%), decreasing from maximum to basic care level hospitals. Conclusions: The survey revealed important structural differences between hospitals of different care levels. Whether these differences have an influence on EOLC remains unclear and needs to be investigated further.