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区域因素如何影响德国的银屑病患者护理?

How do regional factors influence psoriasis patient care in Germany?

机构信息

CVderm - Competence Center for Healthcare Research in Dermatology, University Hospital, Hamburg-Eppendorf, Hamburg, Germany.

出版信息

J Dtsch Dermatol Ges. 2010 Jul;8(7):516-24. doi: 10.1111/j.1610-0387.2010.07358.x. Epub 2010 Feb 12.

Abstract

BACKGROUND

Two national surveys conducted in 2005 and 2007 indicated deficits in psoriasis care in Germany, although there has been a notable nationwide improvement within this period. It remained unclear whether regional differences in psoriasis health care have an influence on patient outcomes in Germany.

AIM

Assessment of regional differences in the health care situation of patient with psoriasis in Germany.

PATIENTS AND METHODS

Nation-wide cross-sectional study in 130 dermatological practices and clinics. Regional classification was based on the affiliation to the Associations of Statutory Health Insurance Physicians. A panel of experts developed eight criteria as indicators of quality of care, among them clinical characteristics and severity of psoriasis (PASI), previous treatments, quality of life and patient-relevant therapeutic benefits.

RESULTS

Care indicators showed marked regional differences. The proportion of patients with preceding systemic or biologic treatment varied between regions. Those regions with high proportions had better results in patient-reported outcomes.

CONCLUSIONS

Differences in economic and regulatory conditions of health care might account for the observed regional variations. Thus, further analyses of these factors are of great importance to assure consistent psoriasis health care in Germany.

摘要

背景

2005 年和 2007 年进行的两项全国性调查表明,德国在银屑病治疗方面存在不足,尽管在此期间全国范围内有显著改善。在德国,银屑病医疗保健方面的地区差异是否会影响患者的治疗结果仍不清楚。

目的

评估德国银屑病患者医疗保健状况的地区差异。

患者和方法

在 130 家皮肤科诊所和诊所进行全国性横断面研究。区域分类基于与法定健康保险医师协会的隶属关系。一个专家组制定了八项作为护理质量指标的标准,其中包括临床特征和银屑病严重程度(PASI)、既往治疗、生活质量和与患者相关的治疗效益。

结果

护理指标显示出明显的地区差异。先前接受系统治疗或生物治疗的患者比例在各地区之间存在差异。那些比例较高的地区在患者报告的结果方面有更好的结果。

结论

医疗保健的经济和监管条件的差异可能是观察到的地区差异的原因。因此,进一步分析这些因素对于确保德国一致的银屑病医疗保健非常重要。

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