[Current status of ambulatory rheumatologic health care in Germany. Structure of health care and range of services].
OBJECTIVE
To gather information on current organizational structures in rheumatologic ambulatory health care in Germany. Based on the results recommendations on future structures will be discussed.


METHODS
This study involved data collection and statistical analysis via a structured 10-page questionnaire among the members of the German Association of Rheumatologists. The questions concerned a variety of topics including information on office structures, patient structure, structure of services offered, co-operation with colleagues and hospitals, quality assurance measures, economic factors, and a subjective assessment of the health care structures in rheumatology by the participants.


RESULTS
Data obtained from 197 rheumatologists who participate in health care were analyzed. In this paper results concerning the organizational as well as the medical ambulatory health care structure will be presented. Data on economic factors will be presented in part 2 of this study.


CONCLUSIONS
The organization of ambulatory treatment regarding processes and treatment differences between office-based physicians and rheumatologic outpatient departments in hospitals was very homogeneous. However, physicians in the eastern regions treated significantly more patients compared with the western parts of Germany. This difference was also observed between the north and south. Differences in patient groups (e.g. underlying diseases) were reported between different sub-groups of rheumatologists (e.g. internal specialists vs. GP vs. orthopedic rheumatologists). Integrated health care, as promoted by German social law, did not play a major role. Overall there was a high level of self-initiated training of physicians and participation in education of patients and other physicians.
Mittendorf
T
T
Forschungsstelle für Gesundheitsökonomie und Gesundheitssystemforschung, Leibniz-Universität Hannover, Königsworther Platz 1, 30167 Hannover, Deutschland. tm@ivbl.uni-hannover.de
Edelmann
E
E
Kekow
J
J
von Hinüber
U
U
Müller-Brodmann
W
W
Graf von der Schulenburg
J-M
JM
D000553:Ambulatory Care / Q000458:organization & administration* / Q000639:trends; D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000639:trends; D005544:Forecasting; D005858:Germany; D006801:Humans; D009313:National Health Programs / Q000458:organization & administration* / Q000639:trends; D010348:Patient Care Team / Q000458:organization & administration / Q000639:trends; D010818:Practice Patterns, Physicians'; D011331:Private Practice / Q000458:organization & administration / Q000639:trends; D012219:Rheumatology; D011795:Surveys and Questionnaires; D014850:Waiting Lists