[Current status and perspectives of ambulatory rheumatologic health care in Germany : economic structural conditions and motivation of rheumatologists].
OBJECTIVE
To gather information about current structures in rheumatologic ambulatory health care in Germany. Based on the results recommendations on future structures will be evaluated.


METHODS
Data collection and statistical analysis via a structured 10-page questionnaire answered by members of the German Association of Rheumatologists. Questions in this second part of the study related to two topics: economic factors and a subjective assessment of the health care structures by the participants.


RESULTS
Data from 197 ambulatory rheumatologists who participated in health care could be included in the analyses. Extensive and detailed data on economic issues surrounding ambulatory patient treatment and practice management from the perspective of ambulatory rheumatologists are presented (e.g., revenue, income, income differences between regions or practice size). In addition, perceptions of participating rheumatologists on future perspectives of patient treatment, health policy, and their own economical survival are reported.


CONCLUSIONS
As in other specialties there is a significant difference not only between the eastern and western regions in Germany but also between the north and the south looking at e.g., revenue, income, with rheumatologists in the east treating significantly more patients. Reasons for those differences are not only related to regional remuneration schemes or the number of patients with a private but statutory health insurance, but are also driven by the number of different services provided (e.g., own laboratory). Physicians perceptions towards their own future in rheumatology are generally positive. Scepticism was reported for the individual economic survival in ambulatory treatment and future changes in health policy.
Mittendorf
T
T
Forschungsstelle für Gesundheitsökonomieund Gesundheitssystemforschung, 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 / Q000191:economics*; D002321:Career Choice; D019411:Clinical Laboratory Techniques / Q000191:economics; D003625:Data Collection; D005104:Expert Testimony / Q000191:economics; D005245:Fee Schedules; D005858:Germany; D006291:Health Policy / Q000191:economics; D006801:Humans; D007182:Income; D009042:Motivation; D009313:National Health Programs / Q000191:economics*; D011216:Practice Management, Medical / Q000191:economics; D010818:Practice Patterns, Physicians' / Q000191:economics; D011331:Private Practice / Q000191:economics; D012017:Referral and Consultation / Q000191:economics; D012219:Rheumatology / Q000191:economics*; D011795:Surveys and Questionnaires