Daikeler R
Arzt für Innere Medizin Diabetologe (DDG), Internistische Gemeinschaftspraxis im Arztehaus Sinsheim, Hauptstr. 71, 74882 Sinsheim, Germany.
Clin Res Cardiol. 2006 Jan;95 Suppl 1:i130-3. doi: 10.1007/s00392-006-1105-0.
It is by DMPs that the legislator intervened in medical care processes in Germany for the first time. Targets of treatment, diagnostic definitions and treatments were determined by legal order. The best available evidence was defined by law. The medical profession has come into conflict with this situation, as with regard to diabetes the legally established evidence-based contents are not apt to consensus, as they deviate significantly not only from the German guideline for the care of diabetes but also from the relevant international guide lines. The patient's entitlement to an appropriate treatment according to the state of the art is not accommodated due to this inconsistency. The cooperation between ambulatory and stationary care units as well as the cooperation between family practitioner and medical specialist is determined by the DMPs in terms of interfaces. Regarding the graduation within the care system an improvement can be anticipated.
正是通过疾病管理项目，德国立法者首次对医疗过程进行了干预。治疗目标、诊断定义和治疗方法由法律规定。法律确定了最佳可得证据。医学界与这种情况产生了冲突，因为就糖尿病而言，法律规定的循证内容无法达成共识，因为它们不仅与德国糖尿病护理指南有很大偏差，也与相关国际指南有很大偏差。由于这种不一致，患者根据现有技术获得适当治疗的权利得不到保障。疾病管理项目在接口方面决定了门诊和住院护理单位之间的合作以及家庭医生和专科医生之间的合作。关于护理系统内的分级，可以预期会有所改善。
