title: Quality of care of patients with chronic lymphoedema in Germany.
abstract: BACKGROUND
  The management of lymphoedema is complex and should be based on guidelines. To date, no data assessing quality of care in lymphoedema in Germany are available.
  
  
  OBJECTIVE
  We aimed at evaluating the quality of care of lymphoedema in the metropolitan area of Hamburg using guideline-based indicators.
  
  
  METHODS
  Cross-sectional, community-based study including patients with lymphoedema. Assessment included a structured interview, clinical examination and patient-reported outcomes. Quality indicators derived from guidelines by a Delphi consensus were applied.
  
  
  RESULTS
  348 patients (median age 60.5 years) with lymphoedema (66.4%), lipoedema (9.5%) or combined oedema (24.1%) were included. 86.4% performed compression therapy, 85.6% received lymphatic drainage. On average 55.0% of the quality of care criteria were met; 64.8% were satisfied with care. The distribution curve of the health care index was almost normal. Treatment by specialists led to a higher quality of care index.
  
  
  CONCLUSIONS
  Although overall quality of care in lymphoedema is fair, many patients are not treated properly according to guidelines.
authors.affiliation: CVderm-German Center for Health Services Research in Dermatology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. k.herberger@uke.uni-hamburg.de
authors.forename: K
authors.initials: K
authors.lastname: Herberger
authors.forename: C
authors.initials: C
authors.lastname: Blome
authors.forename: A
authors.initials: A
authors.lastname: Sandner
authors.forename: F
authors.initials: F
authors.lastname: Altheide
authors.forename: K
authors.initials: K
authors.lastname: Heyer
authors.forename: K C
authors.initials: KC
authors.lastname: Münter
authors.forename: W R
authors.initials: WR
authors.lastname: Gottlieb
authors.forename: M
authors.initials: M
authors.lastname: Augustin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D019058:Community Networks / Q000592:standards*; D003430:Cross-Sectional Studies; D003697:Delphi Technique; D003880:Dermatology; D004322:Drainage; D005260:Female; D058006:General Practice; D005858:Germany; D019983:Guideline Adherence; D006176:Gynecology; D006801:Humans; D007388:Internal Medicine; D008209:Lymphedema / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic; D019984:Quality Indicators, Health Care; D011788:Quality of Life; D053828:Stockings, Compression; D011795:Surveys and Questionnaires; D055815:Young Adult