Einfluss der Krankenhausstrukturreform und sozio-ökonomischer Deprivation in NRW auf die Erreichbarkeit spezialisierter stationärer Palliativversorgung

Palliative care aims to improve the quality of life for patients with potentially life-threatening illnesses and their families by early identification and treatment of physical, psychosocial, and spiritual suffering and symptoms. The aim of this study was to examine the impact of the hospital structural reform in North Rhine-Westphalia (NRW, 01.04.2025) on the accessibility of facilities offering specialized inpatient palliative care.Hospitals providing specialized inpatient palliative care were identified through the Palliative Care Registry and the §136b data submitted to the Joint Federal Committee (G-BA). The average weighted travel times to these facilities were calculated and compared with the future locations proposed under the NRW hospital structural reform in service group 29, "Palliative Care." Accessibility was correlated with socio-economic deprivation (German Index of Socioeconomic Deprivation, GISD) at the municipal level.A total of 162 hospitals in NRW offering specialized palliative care were identified. In 2022, the average weighted travel time to these hospitals was 11.4 minutes, with 53% of the population able to reach a hospital within 10 minutes and 97% within 30 minutes. No significant correlation was found between the accessibility of specialized inpatient palliative care facilities and socio-economic deprivation. Under the planned hospital structural reform, the average travel time is expected to increase to 12.2 minutes; 48% of the population will be able to reach a palliative care facility within just under 10 minutes, and 96% within 30 minutes.The results suggest that the planned reform will have only a marginal impact on the accessibility of specialized palliative care in NRW. Although average travel times are expected to increase slightly, access will still remain feasible for the majority of the population within a short timeframe.