Care situation of diabetes mellitus patients in german hospitals - How to proceed strategically to achieve adequate structural and process management [Versorgungssituation von patienten mit diabetes mellitus an deutschen krankenh?usern: Strategien eines ad?quaten struktur- und prozessmanagements]

摘要

To date, data on the prevalence of diabetes mellitus in German hospitals have been insufficient. A several-years' study (Ludwigshafen-Limburg Diabetes Model Study) revealed definitely a prevalence of approximately 30% as well as 75% confirmed subsequent complications in all hospitalized patients. Hence, diabetes mellitus is one of the most frequent concomitant diseases of in-patients. Actually, however, the concomitant diagnosis "diabetes mellitus" has so far been established in only 10% of all in-patients and the subsequent complications have been recognized in only 10% of these. Diabetic patients hospitalized as emergency cases for other reasons are definite safety risks that have so far hardly been recognized or systematically recorded as diabetics. Treatment quality can be improved by adequate structural and process management and the in-hospital period significantly reduced and cost saved. Adequate CCL-relevant coding can contribute to a considerable saving of cost. These structures can be effectively translated into reality only by means of qualified diabetology and super-departmentological competence without any departmentally defined restrictions. A structurally defined management of diabetes must be available for treating these patients. This management set-up must include inter alia an adequate training of the physicians and care personnel as well as algorithms for treatment in a variety of situations. This specific procedural catalog is being presented all over Germany in on-target multiprofessional management seminars (DEC seminars). Among others, specifically the German Hospitals Society and the cost-bearers are addressed to realize adequate structures.