[New legal regulations for palliative care with implications for politics and practice]

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2017 Jan;60(1):4-10. doi: 10.1007/s00103-016-2480-y.
[Article in German]

Abstract

In December 2015 two different laws were adopted. Both are of importance for palliative care. One of the laws criminalizes commercial, "business-like" assisted suicide (§ 217 German Criminal Code), the other one aims to improve hospice and palliative care in Germany. Through the latter far-reaching changes in Social Code Books V and XI, as well as of the Hospital Finance Act have been made. This new Act to Improve Hospice and Palliative Care (HPG) focuses, amongst others, on: (a) Better funding of hospice services, by raising the minimum grant for patients in inpatient hospices paid per day by the health insurance funds by about 28.5%, and for outpatient hospice services by about 18%; (b) further development of general outpatient nursing and medical palliative care, and the networking of different service providers; (c) introduction of an arbitration procedure for service provider agreements to be concluded between the health insurance funds and the teams providing specialized home palliative care (SAPV); (d) the right to individual advice and support by the health insurance funds; (e) care homes may offer their residents advance care planning programs to be funded by the statutory health insurers; (f) palliative care units in hospitals can be remunerated outside the DRG system by per diem rates; (g) separate funding and criteria for multi-professional palliative care services within a hospital.While little concrete impact on hospice and palliative care can be expected following the new § 217 German Criminal Code, the HPG provides a good basis to improve care. For this purpose, however, which complementary and more concrete agreements are made to put the new legal regulations into practice will be crucial.

Keywords: Act to Improve Hospice and Palliative Care; Assisted dying; Legal regulations; Palliative care; Specialized home palliative care service.

MeSH terms

  • Germany
  • Health Policy / economics
  • Health Policy / legislation & jurisprudence
  • Hospice Care / economics
  • Hospice Care / legislation & jurisprudence*
  • Humans
  • National Health Programs / economics
  • National Health Programs / legislation & jurisprudence*
  • Palliative Care / economics
  • Palliative Care / legislation & jurisprudence*
  • Politics
  • Reimbursement Mechanisms / economics
  • Reimbursement Mechanisms / legislation & jurisprudence*
  • Suicide, Assisted / economics
  • Suicide, Assisted / legislation & jurisprudence*
  • Terminally Ill / legislation & jurisprudence*