[Patient contact supported effectiveness evaluation of legal guidelines on ambulatory care]

A network of about 100 physicians (general practitioners, internists) has been introduced in Lower Saxony, Germany. The participating physicians report on a sample of their patient contacts involving frequent complaints (e.g. vertigo, leg problems, pain due to rheumatic conditions, and gastrointestinal disturbances). The project combines individual, problem-specific patient monitoring with the physicians' estimation of both the conditions under which they conduct their practice and the state of the regional health care system. A standardized questionnaire records sociodemographic variables and major reasons for the patients' visit. It also records data about diagnoses, diagnostic and therapeutic strategies and changes in therapy. In 1993 special attention was given to an assessment of recent health care cost containment legislation and its effects upon the quality of ambulatory medical care. 1400 patient contacts have been reported on in the first two surveys. Results are presented in this article.