Has the Early Majority Been Reached? Specialised Inpatient Palliative Care Utilisation in Common Solid Tumours in Germany.
6 affiliations
- 1Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 15562 Rüdersdorf bei Berlin, Germany.
- 2Immanuel Clinic Rüdersdorf, Universitätsklinikum der MHB, 15562 Rüdersdorf bei Berlin, Germany.
- 3ALPHA Rheinland, 53111 Bonn, Germany.
- 4Department of Neurosurgery, Jena University Hospital, Friedrich-Schiller University, 07747 Jena, Germany.
- 5Independent Researcher, 15834 Rangsdorf bei Berlin, Germany.
- 6Department of Palliative Medicine, University Hospital Bonn, 53127 Bonn, Germany.
Abstract
Background: Randomised trials indicate that early integration of specialised palliative care improves quality of life and, in some studies, survival in advanced cancer, yet its implementation in inpatient oncology remains inconsistent. This study quantifies the coded utilisation of specialised inpatient palliative care in German hospitals and interprets adoption patterns using the diffusion of innovations theory. Methods: We conducted a cross-sectional analysis of nationwide hospital cases reimbursed under the German diagnosis-related groups (DRG) system in 2023. The analysis included the most common solid malignancies and assessed the utilisation of specialised inpatient palliative care overall and stratified by metastatic status, tumour entity, comorbidities, and treating medical specialties. Results: Specialised inpatient palliative care was provided in 5.4% of hospital cases involving the most common malignant tumours. Among patients with organ metastases, utilisation increased to a median rate of 15.0% of hospital cases, with the highest rates observed in cases with brain (17.8%), bone (17.0%), and pleural metastases (16.1%). Palliative care involvement correlated positively with in-hospital mortality. Interpreted cautiously through the diffusion of innovations theory, which frames the 15 to 20% band as a heuristic landmark rather than a validated threshold, utilisation even in the metastatic subgroup reaches only the lower edge of this band, indicating that uptake remains confined to innovators and early adopters and has not extended to the early majority. Conclusions: Specialised inpatient palliative care remains underutilised in German oncology, reaching 5.4% of all cases and a median of 15.0% even in metastatic disease. Interpreted cautiously through the diffusion of innovations theory, which frames the 15 to 20% band as a heuristic landmark, uptake appears confined to early adopters and has not yet reached the early majority.
Related
- Who Is Reached by Supervised Psilocybin Services? Oregon Services Versus National Psilocybin Use
- Why Patient-Reported Outcome Measures Have Not Reached Primary Eye Care: A Critical Narrative Review of the Targeting, Access, and Action Gaps
- Innovation in medical surge capacity during the 2026 Venezuela earthquake response: operationalising a Specialised Care Team for Emergency Remote Clinical Support
- Éliminer l’utilisation du protoxyde d’azote
- Patients' experiences of and adherence to supervised high-intensity physical training integrated into specialised treatment for substance use disorders: study protocol for a qualitative collaborative health services study of facilitators and barriers.
BibTeX
@article{kamp2026early,
title = {{Has the Early Majority Been Reached? Specialised Inpatient Palliative Care Utilisation in Common Solid Tumours in Germany.}},
author = {Marcel A Kamp and Martina Kern and Nazife Dinc and Birgitt van Oorschot and Lukas Radbruch and Christiane von Saß},
journal = {Cancers},
year = {2026},
month = oct,
doi = {10.3390/cancers18193163},
url = {https://europepmc.org/article/MED/42882857},
note = {CC BY},
}
RIS
TY - JOUR
TI - Has the Early Majority Been Reached? Specialised Inpatient Palliative Care Utilisation in Common Solid Tumours in Germany.
AU - Marcel A Kamp
AU - Martina Kern
AU - Nazife Dinc
AU - Birgitt van Oorschot
AU - Lukas Radbruch
AU - Christiane von Saß
PY - 2026
DA - 2026/10/01
JO - Cancers
DO - 10.3390/cancers18193163
UR - https://europepmc.org/article/MED/42882857
AB - Background: Randomised trials indicate that early integration of specialised palliative care improves quality of life and, in some studies, survival in advanced cancer, yet its implementation in inpatient oncology remains inconsistent. This study quantifies the coded utilisation of specialised inpatient palliative care in German hospitals and interprets adoption patterns using the diffusion of innovations theory. Methods: We conducted a cross-sectional analysis of nationwide hospital cases reimbursed under the German diagnosis-related groups (DRG) system in 2023. The analysis included the most common solid malignancies and assessed the utilisation of specialised inpatient palliative care overall and stratified by metastatic status, tumour entity, comorbidities, and treating medical specialties. Results: Specialised inpatient palliative care was provided in 5.4% of hospital cases involving the most common malignant tumours. Among patients with organ metastases, utilisation increased to a median rate of 15.0% of hospital cases, with the highest rates observed in cases with brain (17.8%), bone (17.0%), and pleural metastases (16.1%). Palliative care involvement correlated positively with in-hospital mortality. Interpreted cautiously through the diffusion of innovations theory, which frames the 15 to 20% band as a heuristic landmark rather than a validated threshold, utilisation even in the metastatic subgroup reaches only the lower edge of this band, indicating that uptake remains confined to innovators and early adopters and has not extended to the early majority. Conclusions: Specialised inpatient palliative care remains underutilised in German oncology, reaching 5.4% of all cases and a median of 15.0% even in metastatic disease. Interpreted cautiously through the diffusion of innovations theory, which frames the 15 to 20% band as a heuristic landmark, uptake appears confined to early adopters and has not yet reached the early majority.
SN - 2072-6694
ER -