[The future is chronic: German primary care and the Chronic Care Model--The comprehensive principles in the proactive treatment of the chronically ill].
BACKGROUND
In Germany, primary healthcare for patients with chronic diseases needs to be improved. Taking the example of depression, congestive heart failure, diabetes and diseases of the musculoskeletal system we analyzed to which extent the 'Chronic Care Model' allows for improvements.


METHODS
Diagnosis-specific health assessment; adaptation of the 'Chronic Care Model' to the German healthcare system; peer reviewed discussions of the potentials for improving primary care of the chronically ill. RESULTS/DISCUSSION OF THE HEALTHCARE SITUATION: 1) Diagnosis and therapy of chronic diseases comply insufficiently with the evidence. 2) Patients are too passive and/or receive only little effective support. 3) Treatments are often uncoordinated and fragmented. 4) The follow-up of treatment results is often neglected. 5) Approaches to indicated diseases are promising.


CONCLUSIONS
The'Chronic Care Model' could improve chronic care in Germany. Disease Management Programs (DMP) should amend multimorbidity and individual healthcare and/or facilitate implementation in general practice.
Gensichen
Jochen
J
Institut fürAllgemeinmedizin, Johann Wolfgang Goethe-Universität Frankfurt am Main. gensichen@allgemeinmedizin.uni-frankfurt.de
Muth
Christiane
C
Butzlaff
Martin
M
Rosemann
Thomas
T
Raspe
Heiner
H
de Cornejo
Gabriele Müller
GM
Beyer
Martin
M
Härter
Martin
M
Müller
Ulrich A
UA
Angermann
Christiane E
CE
Gerlach
Ferdinand M
FM
Wagner
Ed
E
D002908:Chronic Disease / Q000628:therapy*; D003695:Delivery of Health Care / Q000592:standards*; D006801:Humans; D011320:Primary Health Care / Q000592:standards*; D011785:Quality Assurance, Health Care