Edelmann E, Lakomek H J, Bessler F, Braun J, Froschauer Sonja, Hellmich B, von Hinüber U, Kalthoff L, Karberg K, Kekow J, Krause A, Müller-Brodmann W, Munte Axel, Ruehlmann J M, Zinke S
Rheumazentrum Bad Aibling Erding, Lindenstr. 2, 83043, Bad Aibling, Deutschland.
Klinik für Rheumatologie, Universitätsklinik für Geriatrie, Johannes Wesling Klinikum Minden, Minden, Deutschland.
Z Rheumatol. 2019 Oct;78(8):765-773. doi: 10.1007/s00393-019-0685-9.
Since April 2018, the new third level care model of outpatient specialist care (ASV) according to §116b of the Social Code Book V (SGBV) has been available for patients with chronic inflammatory rheumatic diseases in Germany. Not only is a multiprofessional cooperation between the disciplines involved in treating rheumatic diseases promoted but also the cooperation between specialized rheumatologists and other specialists in private practice and in hospitals is encouraged. As budget capping limiting services and number of cases do not apply in ASV, a significant improvement of patient care in rheumatology is expected due to an increase in provider capacity. At the end of May 2019, 72 rheumatologists in the first 9 newly approved ASV teams had qualified for this new care concept. Bureaucratic obstacles have so far delayed the implementation of ASV. Difficulties arose in building a team with different specialties, in the process of registration of the teams and the assessment of the registration by certain regional boards responsible for access control. The national associations of rheumatologists, the Professional Association of German Rheumatologists (BDRh), the VRA (Verband der Rheumatologischen Akutkliniken e. V.) and the German Society of Rheumatology (DGRh) campaign for an easier admission of providers to the ASV and for adequate financing of all specialties involved in the ASV. The aim is to realize the chance of the ASV for better rheumatological care nationwide with shorter waiting times for a medical appointment and a better cooperation between specialists.
自2018年4月起，德国依据《社会法典》第五卷（SGBV）第116b条规定的门诊专科护理新三级护理模式（ASV）已可供慢性炎性风湿性疾病患者使用。这不仅促进了参与治疗风湿性疾病的各学科之间的多专业合作，还鼓励了专科风湿病医生与私人执业及医院中的其他专科医生之间的合作。由于ASV不适用限制服务和病例数量的预算上限，预计随着服务提供者能力的提升，风湿病患者护理将得到显著改善。截至2019年5月底，首批9个新获批的ASV团队中的72名风湿病医生已符合这一新护理理念的要求。到目前为止，官僚主义障碍延缓了ASV的实施。在组建具有不同专业的团队、团队注册过程以及某些负责准入控制的地区委员会对注册进行评估时出现了困难。德国风湿病医生全国协会、德国风湿病医生专业协会（BDRh）、VRA（急性风湿病诊所协会）和德国风湿病学会（DGRh）开展活动，争取使服务提供者更易加入ASV，并为ASV涉及的所有专业提供充足资金。目标是在全国范围内实现ASV带来的改善风湿病护理的机会，缩短预约就诊等待时间，并促进专科医生之间更好的合作。
