Prevalence of chronic diseases and quality indicators in general practice in Bremen
DOI: 10.3238/zfa.2009.0187german translation / full article
Background: Despite the high prevalence of chronic diseases and the associated economic burden data on the prevalence of these diseases in general practice in Germany are sparse. We investigated whether our subjective impression regarding the necessities of chronic care correlates with reality i.e. statistics of our own patients, and whether treatment success can be shown.
Methods: Data about disease prevalence and different quality indicators were collected from 2004–2007. We focussed on the forth quarter of these years and used our own software. Quality indicators had been documented for the corresponding patients in the software of the surgery as pseudo diagnoses or as pseudo accounting items.
Results: The prevalence of chronic diseases in our general practice office is high. 38 % of the patients carry at least one of the following diagnoses: hypertension, diabetes mellitus type 2 or bronchial asthma. Using systematic evaluation of the statistical findings und implementing changes in daily practice accordingly, we achieved to improve the outcome regarding most quality indicators.
Conclusions: Focussing on diagnoses instead of states of illness moves away from the traditional approach of general practice. We did it nevertheless for reasons of practicability. Registration of prevalence of chronic diseases in general practice is complex and time-consuming, but it is feasible using the practice software, and may help to improve chronic care. Searching continuously allows to identify deficits in health care of people with chronic diseases and to initiate targeted efforts for amelioration.