Characterization of individuals in home-based intensive care in Germany: data from a cross-sectional study

In Germany, approximately 23.000 individuals require home-based intensive care (HIC) provided by specialized nurses due to life-threatening conditions such as invasive ventilation, life-supporting noninvasive ventilation, or the presence of tracheal tubes requiring tracheobronchial suctioning. The current study's objective was to characterize individuals receiving home-based intensive care from a private German provider to inform healthcare structures and clinical practice guidelines.

On June 12, 2024, the quality management department of a private German home-based intensive care service collected cross-sectional data on all individuals receiving home-based intensive care.

Data from 851 individuals were collected, of which 511 (60%) were sixty years or older. Three hundred and thirty two individuals (39%) were female and 519 (61%) were male. Seven hundred and thirty four individuals (86%) were living in shared apartments and 117 (14%) lived at home with 24 h individual nursing care. Six hundred and eighty two individuals (80%) suffered from various neurological diseases, 116 (14%) from COPD, and 30 (4%) from oral, pharyngeal or laryngeal cancer. Twenty seven individuals (3%) had been admitted to HIC after a COVID-19 infection. Seven hundred and forty one individuals (89%) were tracheostomized, 220 (26%) needed invasive ventilation, 44 (5%) noninvasive ventilation and 14 (2%) hemodialysis.

In Germany, neurological diagnoses and COPD are predominant in HIC. Most individuals are tracheostomized, and one in four requires invasive ventilation via tracheostomy. They also require multidisciplinary care by neurologists, pulmonologists, specialist nurses, respiratory therapists, speech-and-language therapists, physiotherapists, occupational therapists and other professionals. Neurological rehabilitation of individuals needing HIC should be established.