Wege zur Verbesserung der Ärztlichen Versorgung an Beispiel der Ambulanten Kassenärztlichen Diabetikerbetreuung

Summary

The transfer of diagnostic and therapeutic concepts based on the experience with hospitalized patients to the field of primary health care is often questionable. Measures to improve out-patient care should arise from the evaluation of data obtained in ambulatory medical practice.

The management of diabetic patients is presented as an example. 12 practising physicians included 163 patients in a randomized crossover trial to whom an intensive dietary counseling by a trained dietary assistent was offered in one phase, and left the patients under usual care conditions in the other phase of 6 months each. Following this trial, which showed a significant improvement of the blood sugar levels in the intensive phase, an observational study on the maintenance of the effects attained is under way. During the course of the study which is performed in constant touch with the diabetologists and the statisticians within the University, a marked improvement of the cooperation between physicians has been achieved.