Department of Dermatology and Allergology, Technical University of Munich, School of Medicine, Munich, Germany,
Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany.
Int Arch Allergy Immunol. 2023;184(6):598-608. doi: 10.1159/000529708. Epub 2023 Apr 4.
Allergic diseases represent a broad spectrum of high-prevalence, chronic conditions that remain underdiagnosed and undertreated. The aims of this interdisciplinary, questionnaire-based, non-interventional study were to identify and analyze potential barriers to clinical allergological care in Germany.
All hospitals listed in the German hospital register involved in the treatment of allergological patients (n = 899) were invited to participate. The study yielded a response rate of 52.1% (n = 468).
Overall, 88.5% of clinics agreed that allergological care in Germany needs improvement, especially in terms of reimbursement for diagnostics and therapy. More than 80% of participating clinics reported that the decreased availability of test substances and the time-intensity of allergological testing represent relevant barriers. For dermatology and pulmonology, the former is the strongest barrier, while for pediatric and ENT clinics, time-intensity is regarded as the strongest barrier. The availability of good therapy and appropriate guidelines present no barriers to allergological care. Regarding the use of digital healthcare concepts, a very large majority of clinics (n = 352; 91.4%) do not offer video consultations or the use of health applications in patient care.
In conclusion, we have identified several structural barriers to allergological care in Germany. Reimbursement and the use of digital healthcare concepts in German clinics providing allergological care need improvement. Based on the results of this study, there is an urgent need for researchers and policymakers to further investigate and support allergology departments in their clinical work and in their implementation of digital healthcare concepts.
过敏疾病是一组广泛存在的高患病率慢性疾病，但这些疾病往往被漏诊和治疗不足。本跨学科、基于问卷的非干预性研究旨在确定和分析德国临床过敏护理的潜在障碍。
邀请德国医院登记册中参与治疗过敏患者的所有医院（n=899）参与研究。研究的回应率为 52.1%（n=468）。
总体而言，88.5%的诊所认为德国的过敏护理需要改进，特别是在诊断和治疗的报销方面。超过 80%的参与诊所报告说，测试物质的可用性降低和过敏测试的时间强度是相关的障碍。对于皮肤科和肺病科，前者是最强的障碍，而对于儿科和耳鼻喉科诊所，时间强度是最强的障碍。良好的治疗和适当的指南的可用性对过敏护理没有障碍。关于数字医疗保健概念的使用，绝大多数诊所（n=352；91.4%）在患者护理中不提供视频咨询或使用健康应用程序。
总之，我们已经确定了德国过敏护理的一些结构性障碍。德国提供过敏护理的诊所的报销和数字医疗保健概念的使用需要改进。基于这项研究的结果，研究人员和政策制定者迫切需要进一步调查和支持过敏科在其临床工作和数字医疗保健概念的实施中。
