Abstract
BACKGROUND: The impact of demographic change has far-reaching consequences for the entire healthcare system. One of the areas particularly affected is palliative and hospice care. To meet the demand for palliative and hospice care services, adequate capacity planning in inpatient and outpatient settings is essential. However, the available capacities per one million inhabitants in Germany vary significantly within the individual regions. METHODS: For an improved assessment of care needs, we propose a simulation-based analysis, carried out both retrospectively for 2019 and prospectively for 2039 for the southern German region of Swabia, and calculate the required capacities of hospices and specialized outpatient palliative care. We focus on cancer patients, as this group represents the largest proportion of patients requiring palliative and hospice care. RESULTS: Driven by demographic change and the increasing incidence of cancer in older age groups, the number of patients requiring palliative care is expected to increase substantially. Accordingly, our results indicate a marked rise in the demand for hospice and specialized outpatient palliative care for cancer patients up to the year 2039. This projected trend underscores the growing care needs within this patient population in the coming decades. CONCLUSION: Our study introduces a simulation-based framework for estimating demand for hospice and specialized outpatient palliative care. By offering a quantitative, mathematical-statistical perspective, the approach complements existing qualitative research and supports informed decision making in palliative care planning. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12904-026-02016-0.