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Nephrol Dial Transplant (2003) 18: 1707-1710
© 2003 European Renal Association-European Dialysis and Transplant Association

Editorial Comment

Disease management programmes: reorganization of healthcare delivery in Germany

Wolf H. Boesken

II. Med Dept der Barmherzigen Brüder, Zentrum Dialyse/Nephrologie, Trier, Germany

Correspondence and offprint requests to: W. H. Boesken, II. Med Dept KH der Barmherzigen Brüder, Zentrum Dialyse/Nephrologie, Nordallee 1, D-54292 Trier, Germany. Email: W.Boesken@bk-trier.de

Keywords: disease management programmes; Germany; healthcare choices; healthcare delivery; health insurance companies

The first 150 words of the full text of this article appear below.

Since 1 July 2002, a legal basis has existed for the drawing up of contracts between physicians and health insurance companies, allowing for the structured treatment of diseases [disease management programmes (DMPs)] for common and economically relevant diseases [1]. DMPs give structured directives to the physician on how to deal with defined medical situations and provide minimum standards for target parameters. Such diagnostic and therapeutic procedures should be developed from evidence-based data and guidelines without limiting the clinical freedom of the physician. DMPs are intended to standardize medical practice and make it measurable, similar to that intended for diagnosis-related groups, the systems adopted to measure items in hospital care. The ultimate aim is to promote competition between healthcare providers and to make medicine more economical. The first two diseases selected for this purpose were type 2 diabetes mellitus and carcinoma of the breast, to be followed by chronic . . . [Full Text of this Article]

Conflict of interests concerning diabetes type 2

The legal situation after introduction of the new law

Intention
Preconditions to be fulfilled by a DMP
Diagnostic criteria
Treatment goals
Interdisciplinary management
Execution of DMPs
Critical evaluation of the programme
The medical profession in the future

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