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  • Title: [Quality assurance in rheumatology].
    Author: Keitel W.
    Journal: Z Rheumatol; 1996; 55(3):143-8. PubMed ID: 8768143.
    Abstract:
    Measurement of quality in health systems was made possible after the introduction of a scientific instrumentarium for assessment of quality. Effectiveness in medical care must be improved in order to stem the rising costs of health care and to prevent rationing measures in medicine. In Germany, quality assurance in medicine is fixed in a legal framework by several laws and statutes. Practice guidelines are one of the means to identify data necessary for decision making. They should be based on a broad consensus among professional, scientific societies, but must also take into consideration possible cost factors and their acceptance by primary care physicians and patients. They should be regularly revised according to the progress in medicine and should leave freedom of decision in individual cases. The Deutsche Gesellschaft für Rheumatologie is editing a comprehensive manual regarding more than 100 individual topics in diagnosis, therapy and complementary care (orthopedic surgery, physical and occupational therapy, rehabilitation). The first part has already been published; it will be completed in 1997 and updated periodically. In the future it is planned to study the quality of care in rheumatic diseases delivered by nonspecialists and specialists and in clinical settings. Furthermore, quality assessment of different treatment regimes is to be continued and expanded. This needs the construction of effective data base for long-term follow-up studies. In the first place however, it is necessary to gain acceptance of our guidelines among general practitioners by participation of rheumatologists in peer reviews and medical audits at community levels.
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