Pfeil Alexander, Fleck Martin, Lorenz Hanns-Martin, Müller-Ladner Ulf, Lakomek Heinz-Jürgen, Specker Christof
Rheumazentrum (G-BA-Kriterien) sowie Sektion Rheumatologie und Osteologie, Klinik für Innere Medizin III, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.
Klinik und Poliklinik für Innere Medizin I, Universitätsklinikum Regensburg, Regenburg, Deutschland.
Z Rheumatol. 2025 Sep 2. doi: 10.1007/s00393-025-01714-z.
The effects of the current hospital reform as well as the increasing shift from inpatient care to outpatient care in Germany will lead to a decline in inpatient training capacities, with the threat of current and future shortages of specialists in outpatient care. This scenario could also affect rheumatology, although the prevalence and complexity of inflammatory rheumatic diseases with systemic organ involvement make comprehensive acute inpatient rheumatology care urgently necessary. The medical, structural and training-related need for inpatient rheumatological care arises not only from the introduction of innovative treatment concepts but also in particular due to highly inflammatory and severe systemic rheumatic diseases with multiorgan involvement as well as from a wide range of comorbidities or the treatment of older people with polypharmacy multimorbidity. The planned amendment of the model advanced training regulations for rheumatism should therefore continue to take an appropriate proportion of inpatient training into account and targeted funding of specialist education is planned as part of the flat-rate payments under the Hospital Care Improvement Act (KHVVG).
德国当前医院改革的影响以及住院治疗向门诊治疗的日益转变，将导致住院培训能力下降，存在当前和未来门诊护理专科医生短缺的风险。这种情况也可能影响风湿病学，尽管累及全身器官的炎性风湿性疾病的患病率和复杂性使得全面的急性住院风湿病护理迫在眉睫。住院风湿病护理在医学、结构和培训方面的需求不仅源于创新治疗理念的引入，特别是由于累及多器官的高度炎性和严重全身性风湿性疾病，还源于多种合并症或对患有多种药物合并症的老年人的治疗。因此，计划对风湿病继续医学教育模式条例进行修订，应继续考虑适当比例的住院培训，并计划在《医院护理改善法》（KHVVG）的统一支付框架下，对专科教育进行有针对性的资助。
