Hülsemann J L, Mattussek S, Zeh S, Zeidler H
Abteilung Rheumatologie, Medizinische Hochschule, Carl-Neuberg-Strasse 1, 30625 Hannover.
Z Rheumatol. 2007 Mar;66(2):142, 144-51. doi: 10.1007/s00393-006-0131-7.
Between 2000 and 2003 the collaborative arthritis center Hanover implemented a quality management program for patients with rheumatoid arthritis (RA). Fourteen rheumatologists in private practice participated in this model project. One of the aims of the project was to improve the cooperation between primary care physicians and rheumatologists. A survey of the primary care physicians was conducted to evaluate rheumatological care.
A total of 340 patients with RA were included in the study. All primary care physicians of these patients were informed about the goals of the project and asked to answer a questionnaire on cooperation with rheumatologists. The questionnaire contained 14 questions and was sent to 270 primary care physicians.
Of the primary care physicians, 83% returned the questionnaire, and 81% percent of these were family practitioners. The primary care physicians treated a mean of 19 patients with RA, of whom 14 were attended in cooperation with rheumatologists. High mean values were found for satisfaction with different aspects of rheumatological patient care on a numerical rating scale from 0 (not satisfied at all) to 10 (completely satisfied). Mean values for satisfaction: diagnosis 7.9, therapy recommendations 7.6, follow-up 7.2,and usefulness of medical report 7.7. A total of 70% of primary care physicians reported difficulties in realizing the recommendations of the rheumatologists. Of the respondents, 90% saw a need for improvement in cooperation with rheumatologists, the most frequently mentioned being the difficulty of consultation with appointments.
This survey of primary care physicians of patients with RA reveals a positive assessment of the cooperation with rheumatologists. The problems which exist mainly concern the realization of recommendations. There is a great requirement for further improvement in the cooperation between primary care physicians and rheumatologists.
2000年至2003年间，汉诺威合作关节炎中心为类风湿关节炎（RA）患者实施了一项质量管理计划。14名私人执业的风湿病学家参与了这个示范项目。该项目的目标之一是改善初级保健医生与风湿病学家之间的合作。对初级保健医生进行了一项调查，以评估风湿病护理情况。
共有340名RA患者纳入本研究。这些患者的所有初级保健医生都被告知该项目的目标，并被要求回答一份关于与风湿病学家合作的问卷。问卷包含14个问题，发送给了270名初级保健医生。
83%的初级保健医生返回了问卷，其中81%是家庭医生。初级保健医生平均治疗19名RA患者，其中14名患者是与风湿病学家合作照料的。在从0（完全不满意）到10（完全满意）的数字评分量表上，对风湿病患者护理不同方面的满意度均值较高。满意度均值：诊断7.9、治疗建议7.6、随访7.2、医疗报告有用性7.7。共有70%的初级保健医生报告在落实风湿病学家的建议方面存在困难。在受访者中，90%认为需要改善与风湿病学家的合作，最常提到的是预约会诊困难。
这项对RA患者初级保健医生的调查显示，对与风湿病学家的合作评价积极。存在的问题主要涉及建议的落实。初级保健医生与风湿病学家之间的合作有很大的进一步改善需求。
