[Health care status of rheumatic patients in rheumatologic centers 1993]

Since 1992 the Federal Minister of Health has supported 21 arthritis centres in all regions of Germany. Their major aim is to improve collaboration between the various experts involved in the health care of arthritis patients. Results of the uniform patient documentation are presented. Compared to previous reports, the collaboration in outpatient care seems to have improved: the majority of patients seen in specialized care is referred within the first two years. Nevertheless, only less than one fourth of the true prevalence of rheumatoid arthritis has been seen by the specialists. There are still deficits concerning comprehensive care like occupational therapy, patient education, and psychological support in coping with pain. There is also a deficit concerning early rehabilitation. This is associated with a high rate of early retirement: 30% of the patients in the working age with a disease duration of five years or more have been retired for health reasons. As it was described in the USA, we found an association of formal education and functional status in patients suffering from rheumatoid arthritis: after having controlled for age, sex, and duration of disease, it became evident that patients with a low educational level have a significantly lower functional capacity.