May 2006
By Joachim Szecsenyi
The German health care system is in a painful reform process with currently a lot of frictions between government, payers and providers.
Some relevant quality projects in the field of general practice are:
- Guideline development: The German College of General Practitioners (DEGAM) has recently published it´s 7th problem-oriented guideline ("ear-pain"). In the year 2007 there are 3 more gudilines to come. More information on the guideline programme can be found at www.degam.de/leitlinien.html
- European Practice Assessment (EPA): There are about 700 GP practices involved in EPA so far. In 2004 the government issued a law which makes the introduction of quality management for all practices mandatory until 2009. More information about EPA can be found at www.aqua-institut.de In the meanwhile a special set of indicators and instruments form an EPA for paediatricians and an EPA for dentists. Practices, which have performed well in EPA can obtain a certificate from "Stiftung Praxissiegel", a joint effort of TOPAS Germany and the Bertelsmann-Foundation. More information at www.praxissiegel.de
- Medical errors: The Frankfurt department of general practice (www.allgemeinmedizin.uni-frankfurt.de) has established an internet-based critical incident reporting system for general practice teams. This system is working quite succesfully under the title "Jeder Fehler zählt" ("every error counts"). More information at www.jeder-fehler-zaehlt.de
- Practice based research networks and indicators: The departments of general practice in Göttingen and Heidelberg with the support of the Federal ministry of Research and Education (BMBF) have established practice based networks to analyse data from medical records based on ICD-10 (www.medvip.uni-goettingen.de) and ICPC-2R (www.content-info.org)
- Quality circles on rational prescribing: These multifaceted interventions have been introduced in different projects the states of Lower-Saxony, Saxony-Anhaltina and Hesse. In Hesse there is currently a project with more than 1.700 practices running in the context of a programme for primary care coordinated health services. More information at www.aqua-institut.de
General information about the german health care sytem (in english and german) can be found at http://www.euro.who.int/observatory
