The primary outcome of this first quantitative part was the reduction of all hospital deaths from 50 \% to 35 \%. The secondary outcome was directing the use of services in favour of the quality of life in the last year of life. The optimal health care spending pattern is considered to be the palliative home care (more contacts with GPs than with physicians in the hospital), with a greater use of symptomatic drugs than of drugs with a glaring life prolonging intention and reduction of distressing diagnostic and therapeutic procedures. To evaluate the implementation in a qualitative way, a multiple case study design was used and focus groups were meant to reveal the strategies every region used in improving the local palliative care organization.
