title: How do regional factors influence psoriasis patient care in Germany?
abstract: BACKGROUND
  Two national surveys conducted in 2005 and 2007 indicated deficits in psoriasis care in Germany, although there has been a notable nationwide improvement within this period. It remained unclear whether regional differences in psoriasis health care have an influence on patient outcomes in Germany.
  
  
  OBJECTIVE
  Assessment of regional differences in the health care situation of patient with psoriasis in Germany.
  
  
  METHODS
  Nation-wide cross-sectional study in 130 dermatological practices and clinics. Regional classification was based on the affiliation to the Associations of Statutory Health Insurance Physicians. A panel of experts developed eight criteria as indicators of quality of care, among them clinical characteristics and severity of psoriasis (PASI), previous treatments, quality of life and patient-relevant therapeutic benefits.
  
  
  RESULTS
  Care indicators showed marked regional differences. The proportion of patients with preceding systemic or biologic treatment varied between regions. Those regions with high proportions had better results in patient-reported outcomes.
  
  
  CONCLUSIONS
  Differences in economic and regulatory conditions of health care might account for the observed regional variations. Thus, further analyses of these factors are of great importance to assure consistent psoriasis health care in Germany.
authors.affiliation: CVderm - Competence Center for Healthcare Research in Dermatology, University Hospital, Hamburg-Eppendorf, Hamburg, Germany. m.radtke@uke.de
authors.forename: Marc Alexander
authors.initials: MA
authors.lastname: Radtke
authors.forename: Jobst
authors.initials: J
authors.lastname: Augustin
authors.forename: Christine
authors.initials: C
authors.lastname: Blome
authors.forename: Kristian
authors.initials: K
authors.lastname: Reich
authors.forename: Stephan J
authors.initials: SJ
authors.lastname: Rustenbach
authors.forename: Ines
authors.initials: I
authors.lastname: Schäfer
authors.forename: Anna
authors.initials: A
authors.lastname: Laass
authors.forename: Matthias
authors.initials: M
authors.lastname: Augustin
mesh_terms: D003430:Cross-Sectional Studies; D003880:Dermatology / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D011565:Psoriasis / Q000453:epidemiology* / Q000628:therapy*; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data*; D016896:Treatment Outcome