Abstracts by keywords: Diabetic foot
Networks for the treatment of people with diabetic foot syndrome (DFS) in North Rhine, Hamburg and Berlin have submitted joint documentation. This is known as the DFS register [1] and is used for quality assurance and the identification of new findings for better care for people with DFS [2, 3]. The networks have taken further quality assurance measures, including certification by the AG Fuß of the German Diabetes Society (DDG), annual internships, training for doctors and assistants, communication tools and quality circles. In particular, they have set up a learning system with shadowing and a completely transparent comparison of all treatment numbers and a discussion about it. They have cared for an increasing number of people with DFS since 2002, with a total of around 60,000 people at the end of 2016. The following health insurance companies support these efforts through selective contracts: AOK Nordost, AOK Rheinland/Hamburg, BARMER, Bundesknappschaft, mhplus BKK, DAK Gesundheit, IKK classic, KKH, pronova BKK and SVLFG. Similar models have been implemented in other regions. This overview compiles the results of all analyzes that have become public in Germany that have examined the effects of specialized care for people with DFS in networks. The evaluations range from surveys in the DFS register to population-based surveys by independent scientists.
24.07.2017
In Germany, an estimated 250,000 people with diabetes currently have a foot lesion and around 1 million diabetics are at increased risk of suffering a foot injury. This makes diabetic foot syndrome (DFS) one of the main complications of patients with diabetes mellitus, with the most significant consequences of diabetic foot problems being ulcers (deep substance defects, commonly ulcers - often in the form of chronic wounds) as well as small (minor) and high (major) Amputations are [1]. Although the DMP diabetes mellitus type 2 has been in existence since 2003 and the DMP diabetes mellitus type 1 since 2005, in which over four million diabetics now take part [2] and thus outpatient care for diabetics has improved overall, they appear to have increased complication rates microangiopathy, especially that of diabetic foot syndrome, does not have a positive effect. When checking the level of target achievement of the fund's own DMP Diabetes, the AOK Nordost noticed that the once-a-year foot examination specified here was not carried out without interruption for all diabetics, and that if an abnormal foot status was detected, there was not always a referral or a late referral to a specialist The treatment and further treatment of the abnormal foot was only initiated with a long delay and amputations occurred, although only low levels of severity were consistently stated in the DMP documentation. In 2011, the “Gesundheitskasse” took this as an opportunity to conclude a contract with doctors who are particularly qualified to care for DFS patients in accordance with Section 73c SGB V, which is intended to improve diabetologically qualified outpatient care for insured persons with DFS. This article presents the first evaluations of the DFS contract, with which AOK Nordost was able to meet its self-imposed goal of reducing amputations among its insured persons with diabetic foot syndrome.