Froschauer Sonja, Muth Theresia, Bredow Laura, Feist Eugen, Heinemann-Dammann Stephan Phillipp, Zinke Silke, Fiehn Christoph
Berufsverband Deutscher Rheumatologen e. V., Dr.-Max-Str. 21, 82031, Grünwald, Deutschland.
Libertamed GmbH, Grünwald, Deutschland.
Z Rheumatol. 2021 Nov;80(9):819-826. doi: 10.1007/s00393-021-01072-6. Epub 2021 Sep 17.
Inflammatory rheumatic diseases affect 1.5 million adults and an estimated 20,000 children and adolescents throughout Germany. The successful treatment of these patients is largely based on the availability of high-quality medical care. To be able to provide sufficient care and prevent long waiting times even though the number of rheumatologists is below demand, efficient practice structures and approaches that go beyond standard care play an important role. The present study takes a look at the current state of rheumatological outpatient care as well as innovative care initiatives to support the service provision structures and to improve the care situation in rheumatology and points out: to ensure guideline-based care despite scarce resources, selective contracts, integrated outpatient specialist care (ASV), early or emergency consultation hours, disease management programs (DMP) and appropriate delegation of medical services play an important role. New care concepts increasingly focus on interdisciplinary cooperation (DMP and ASV), strengthened self-management through structured patient training (DMP) and targeted patient management through screening tools. To ensure an up to date and high-quality treatment in the long term, an increase in further training in rheumatology is necessary. This should be achieved by attracting more students and, if necessary, adjusting the training system.
在德国,炎性风湿性疾病影响着150万成年人以及约2万名儿童和青少年。这些患者的成功治疗很大程度上取决于高质量医疗服务的可及性。尽管风湿病专家数量低于需求,但为了能够提供足够的护理并避免长时间等待,超越标准护理的高效实践结构和方法发挥着重要作用。本研究审视了风湿科门诊护理的现状以及支持服务提供结构和改善风湿病护理状况的创新护理举措,并指出:尽管资源稀缺,但为确保基于指南的护理,选择性合同、综合门诊专科护理(ASV)、早期或急诊咨询时间、疾病管理项目(DMP)以及适当的医疗服务委托都发挥着重要作用。新的护理理念越来越注重跨学科合作(DMP和ASV),通过结构化患者培训(DMP)加强自我管理,并通过筛查工具进行有针对性的患者管理。为确保长期提供最新的高质量治疗,有必要增加风湿病方面的进一步培训。这应通过吸引更多学生并在必要时调整培训体系来实现。