TY  - JOUR
AU  - Rakuša, Elena
AU  - Reinke, Constantin
AU  - Doblhammer, Gabriele
AU  - Radbruch, Lukas
AU  - Schmid, Matthias
AU  - Welchowski, Thomas
TI  - Dementia as a predictor of palliative care: Uncovering patient patterns based on German claims data.
JO  - BMC palliative care
VL  - 24
IS  - 1
SN  - 1472-684X
CY  - London
PB  - BioMed Central
M1  - DZNE-2025-00328
SP  - 46
PY  - 2025
AB  - Palliative care aims to ensure a dignified and self-determined life for people facing the end of life. While palliative care is established for tumor diseases, it's notably absent from German medical guidelines for other progressive diseases with an unfavorable prognosis such as dementia. This study will identify predictors of palliative care use in older patients and explore how these predictors relate to the probability of palliative care.We used data from the largest German health insurance company of people over 50 years of age from the period 2014-2019. The analysis focused on the last year of life. Outcomes were outpatient and inpatient palliative care and predictors were demographics, comorbidities, therapeutic remedies and rehabilitation, care and medical interventions, medication and patient group. Combined logistic regression models and discrete conditional inference survival forests were used to predict the utilization of outpatient and inpatient palliative care. For evaluation we used concordance-index and calibration plots. We identified the most important predictors by using a permutation approach and the log-loss metric.The study cohort for the analysis of inpatient palliative care comprised 43,896 patients, while the cohort for the analysis of outpatient palliative care included a total of 37,430 patients. The models had appropriate discriminatory power (inpatient palliative care: concordance-index = 0.737 (95
KW  - Humans
KW  - Palliative Care: methods
KW  - Palliative Care: statistics & numerical data
KW  - Palliative Care: standards
KW  - Germany
KW  - Female
KW  - Male
KW  - Aged
KW  - Dementia: therapy
KW  - Middle Aged
KW  - Aged, 80 and over
KW  - Cohort Studies
KW  - Insurance Claim Review: statistics & numerical data
KW  - Dementia (Other)
KW  - End-of-life (Other)
KW  - Machine learning (Other)
KW  - Palliative care (Other)
KW  - Predictions (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:39966759
DO  - DOI:10.1186/s12904-025-01672-y
UR  - https://pub.dzne.de/record/276803
ER  -