title: [Memorandum of the German Society for Rheumatology on the quality of treatment in rheumatology - Update 2016].
abstract: On behalf of the Steering Committee of the German Society for Rheumatology, in 2016 the Interdisciplinary Commission on Healthcare Quality updated the 2008 memorandum on rheumatological healthcare in Germany. The update considers changes in therapeutic strategies, treatment targets as well as current structures in healthcare and the political framework. It concentrates on examination of the need for rheumatologists with a background in internal medicine and determines the gap between needs and supply. The internist rheumatologist is responsible for the care of patients with inflammatory rheumatic diseases and contributes to the care of patients with severe forms of other musculoskeletal diseases. At least 2 internist rheumatologists are needed for the outpatient care of 100,000 adult inhabitants, equivalent to 1350 rheumatologists in Germany. With currently 776 rheumatologists, we have little more than half of what we need. The German Society for Rheumatology calls for specific requirements planning for rheumatologists in outpatient care in order to decrease the deficit. In acute inpatient care we need specialized hospitals and wards that ensure a high quality of treatment for patients with complex diseases. We need up to 50 beds per 1 million inhabitants. At least 2 full-time internist rheumatologists and 3 further physicians are needed per 30 beds. In inpatient and outpatient rehabilitation we need 40 beds or outpatient places per 1 million inhabitants with at least 1 full-time rheumatologist and 1 further physician. In order to reduce the existing deficits and to cover the increasing future need for rheumatologists, more emphasis has to be laid on primary and secondary education. Chairs for internal rheumatology are needed at each medical university and more positions for postgraduate training in rheumatology should be provided. In all segments of healthcare the treatment aims should be jointly defined between patients and physicians. The patients should be treated in an interdisciplinary network, comprising other medical specialties, health professionals as well as patient organizations.
authors.affiliation: Deutsches Rheuma-Forschungszentrum Berlin, Programmbereich Epidemiologie und Klinik mit Schwerpunkt Rheumatologie und Klinische Immunologie, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland. zink@drfz.de.
authors.forename: A
authors.initials: A
authors.lastname: Zink
authors.affiliation: Rheumazentrum Ruhrgebiet, Herne, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Braun
authors.affiliation: Deutsche Rheuma-Liga Bundesverband, Bonn, Deutschland.
authors.forename: E
authors.initials: E
authors.lastname: Gromnica-Ihle
authors.affiliation: Internistische und rheumatologische Gemeinschaftspraxis, Gladbeck, Deutschland.
authors.forename: D
authors.initials: D
authors.lastname: Krause
authors.affiliation: Klinik für Rheumatologie und Interdisziplinäre Geriatrie, Universitätszentrum Innere Medizin, Johannes Wesling Klinikum Minden, Minden, Deutschland.
authors.forename: H J
authors.initials: HJ
authors.lastname: Lakomek
authors.affiliation: Institut für Rehabilitationsmedizin, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland.
authors.forename: W
authors.initials: W
authors.lastname: Mau
authors.affiliation: Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie, Justus-Liebig-Universität Gießen, Gießen, Deutschland.|Abteilung Rheumatologie und klinische Immunologie, Kerckhoff-Klinik GmbH, Bad Nauheim, Deutschland.
authors.forename: U
authors.initials: U
authors.lastname: Müller-Ladner
authors.affiliation: Deutsche Gesellschaft für Rheumatologie, Berlin, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Rautenstrauch
authors.affiliation: Klinik für Rheumatologie & Klinische Immunologie, Rheumazentrum Rhein-Ruhr e.V., St. Josef Krankenhaus (Universitätsklinikum Essen), Essen, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Specker
authors.affiliation: Poliklinik und Funktionsbereich für Rheumatologie, Hiller Forschungszentrum Rheumatologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Schneider
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data*; D005858:Germany; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data*; D006801:Humans; D020380:Needs Assessment / Q000706:statistics & numerical data*; D015995:Prevalence; D012216:Rheumatic Diseases / Q000453:epidemiology* / Q000628:therapy*; D000072140:Rheumatologists / Q000706:statistics & numerical data / Q000600:supply & distribution*; D012219:Rheumatology; D000078329:Workforce
keywords: Education; Inpatients; Musculoskeletal diseases; Outpatient care; Rehabilitation