{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T10:49:58Z","timestamp":1786618198680,"version":"build-2736575974"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gesundheitswesen"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Palliativmedizin zielt darauf ab, die Lebensqualit\u00e4t von Patient*innen mit\n                        potenziell lebensbedrohlichen Erkrankungen und deren Angeh\u00f6rigen zu\n                        verbessern, indem Leiden und Symptome in k\u00f6rperlicher, psychosozialer und\n                        spiritueller Hinsicht fr\u00fchzeitig erkannt und behandelt werden. Die\n                        vorliegende Studie untersucht die Auswirkungen der am 01.04.2025 in Kraft\n                        getretenen Krankenhausstrukturreform in Nordrhein-Westfalen (NRW) auf die\n                        Erreichbarkeit von Einrichtungen mit spezialisierter station\u00e4rer\n                        palliativmedizinischer Versorgung.<\/jats:p>\n                  <jats:p>Krankenh\u00e4user mit spezialisierter station\u00e4rer Palliativversorgung wurden \u00fcber\n                        das Palliativregister und die \u00a7136b Daten an den Gemeinsamen Bundesausschuss\n                        identifiziert. Mittlere gewichtete Fahrzeiten zu diesen Einrichtungen wurden\n                        ermittelt und mit den Standorten verglichen, die im Rahmen der\n                        Krankenhausstrukturreform NRW in der Leistungsgruppe 29 \u201ePalliativmedizin\u201c\n                        vorgesehen sind. Die Erreichbarkeit wurde mit der sozio\u00f6konomischen\n                        Deprivation (German Index of Socioeconomic Deprivation, GISD) auf\n                        Gemeindeebene korreliert.<\/jats:p>\n                  <jats:p>Insgesamt wurden 162 Kliniken in NRW identifiziert, die spezialisierte\n                        palliativmedizinische Versorgung anbieten. Im Jahr 2022 betrug die mittlere\n                        gewichtete Fahrzeit zu diesen Kliniken 11,4\u2009min, wobei 53% der Bev\u00f6lkerung\n                        eine Klinik innerhalb von 10 Minuten und 97% in 30\u2009min erreichen konnten. Es\n                        zeigte sich keine signifikante Korrelation zwischen der Erreichbarkeit\n                        spezialisierter station\u00e4rer palliativmedizinischer Einrichtungen und der\n                        sozio\u00f6konomischen Deprivation. Im Rahmen der Krankenhausstrukturreform wird\n                        die mittlere Fahrzeit auf 12,2\u2009min ansteigen. 48% der Bev\u00f6lkerung werden\n                        eine Klinik mit Palliativmedizin innerhalb von knapp 10\u2009min und 96% in\n                        30\u2009min erreichen.<\/jats:p>\n                  <jats:p>Die Ergebnisse legen nahe, dass die geplante Reform nur einen marginalen\n                        Einfluss auf die Erreichbarkeit spezialisierter palliativmedizinischer\n                        Versorgung in NRW haben wird. Obwohl die durchschnittlichen Fahrzeiten\n                        geringf\u00fcgig ansteigen, bleibt der Zugang f\u00fcr die Mehrheit der Bev\u00f6lkerung\n                        weiterhin innerhalb kurzer Zeit realisierbar.<\/jats:p>","DOI":"10.1055\/a-2633-5943","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T22:39:54Z","timestamp":1758839994000},"page":"250-259","source":"Crossref","is-referenced-by-count":3,"title":["Einfluss der Krankenhausstrukturreform und sozio-\u00f6konomischer\n                    Deprivation in NRW auf die Erreichbarkeit spezialisierter station\u00e4rer\n                    Palliativversorgung"],"prefix":"10.1055","volume":"88","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7259-8492","authenticated-orcid":false,"given":"Christiane","family":"von Sass","sequence":"additional","affiliation":[{"name":"Palliative Care, Brandenburg Medical School Theodor Fontane, R\u00fcdersdorf\n                    bei Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Wedding","sequence":"additional","affiliation":[{"name":"Abteilung Palliativmedizin, Universit\u00e4tsklinikum Jena, Jena,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Bergmann","sequence":"additional","affiliation":[{"name":"Healthcare Analytics, Trinovis GmbH, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larissa","family":"Fink","sequence":"additional","affiliation":[{"name":"Palliative Care, Brandenburg Medical School Theodor Fontane, R\u00fcdersdorf\n                    bei Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jil","family":"Adelstein","sequence":"additional","affiliation":[{"name":"Healthcare Analytics, Trinovis GmbH, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit","family":"van Oorschot","sequence":"additional","affiliation":[{"name":"Palliative Care, Julius-Maximilians-Universit\u00e4t W\u00fcrzburg Medizinische\n                    Fakult\u00e4t, W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Muehlensiepen","sequence":"additional","affiliation":[{"name":"Zentrum f\u00fcr Versorgungsforschung, Brandenburg Medical School Theodor\n                    Fontane, R\u00fcdersdorf bei Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel Alexander","family":"Kamp","sequence":"additional","affiliation":[{"name":"Palliative Care, Brandenburg Medical School Theodor Fontane, R\u00fcdersdorf\n                    bei Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,9,25]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1177\/014107680109400904","article-title":"The evolution of palliative care","volume":"94","author":"C Saunders","year":"2001","journal-title":"J R Soc Med"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1080\/13520806.1972.11759235","article-title":"The care of the dying patient and his family","author":"C Saunders","year":"1975","journal-title":"Doc Med Ethics"},{"key":"ref3","volume-title":"WHO definition of palliative care. 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