AB1344 THE FUTURE OF RHEUMATOLOGICAL CARE IN GERMANY: ASSESSMENT, SHORTFALLS AND SOLUTION PROPOSALS
Authors: K. Albrecht, J. Braun, J. Callhoff, I. Haase, A. Krause, H. J. Lakomek, D. Meyer-Olson, R. Schmale-Grede, A. Voormann, U. Wagner, J. Zeidler, S. Zinke, C. Specker
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> In Germany, as in many other countries, there is an increasing shortage of rheumatologists, which jeopardises the provision of needs-based care for people with inflammatory rheumatic diseases (iRMDs). <h3>Objectives:</h3> To provide current data on rheumatology healthcare resources, workforce supply, access to care, quality of care, economic burden, education and training in rheumatology in Germany. The project was initiated by the German Society for Rheumatology (DGRh), with participation of the Professional Association of Rheumatologists (BDRh), the Association of Acute Rheumatology Clinics (VRA), the German Rheumatism Research Centre (DRFZ) and the patient organization German League against Rheumatism (DRL). <h3>Methods:</h3> Currently available data were collected on the prevalence of iRMDs, the number of rheumatology departments, rheumatologists and work settings including in-/outpatient care, rehabilitation, full-/part-time work, female/male ratio and regional variation. Quality and gaps of care, the number of academic departments, rheumatology trainees and nurses, and healthcare costs of iRMDs were assessed. <h3>Results:</h3> About 1.8 million adults in Germany suffer from an iRMD. The prevalence is increasing due to the demographic change. At least two rheumatologists per 100,000 adults are regarded to be required for needs-based care, currently there is only one rheumatologist per 100,000 adults, with considerable regional variation. One third of rheumatologists are older than 60 years. Part-time employment and the proportion of females is increasing. The current average working hours are above the defined full-time employment. Every year, around 60 trainees take the rheumatologist examination. Specialized rheumatologic nurses are increasingly involved in outpatient care. The average waiting time for a first appointment is often more than three months. The direct costs in Germany for the treatment of inflammatory polyarthropathies (ICD-10GM M05-M14) alone totalled €3 billion in 2020. <h3>Conclusion:</h3> The current training rate is not sufficient to compensate for the increasing workload and the loss of patient care capacity due to retirement of many rheumatologists and increase in part-time work. Alongside financial and structural support for rheumatological training, team-based care needs to be financially supported. Research is ongoing on further ways of reducing the work load through digitally supported rheumatological care. Demands are being addressed to policy-makers to overcome the supply shortage. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Katinka Albrecht: None declared, Juergen Braun: None declared, Johanna Callhoff Janssen, Pfizer, Idorsia, Abbvie, AstraZeneca, BMS, Galapagos, GSK, Medac, MSD, Pfizer, UCB, Lilly, Sanofi-Aventis, Isabell Haase Abbvie, AstraZeneca, Boehringer Ingelheim, Galapagos, GSK, Janssen, Lilly, Medac, Novartis, UCB, AbbVie, Celgene, Chugai, Hexal, Janssen, Medac, UCB, Andreas Krause: None declared, Heinz-Jürgen Lakomek: None declared, Dirk Meyer-Olson: None declared, Rotraud Schmale-Grede: None declared, Anna Voormann: None declared, Ulf Wagner: None declared, Jan Zeidler: None declared, Silke Zinke: None declared, Christof Specker: None declared.