[Rigid RSA DMP for Type-2 Diabetes Mellitus: results of a three-state survey].

Diabetes contracts, such as those used in Saxony, were already excellent, effective diabetes programs in line with the concept of disease management. This was due to well-accepted practical guidelines and to an integrated care concept that was implemented with little bureaucratic effort through an internal quality-control management; this was based in turn on rapid, practicable documentation in the framework of interdisciplinary quality round tables. The present RSA DMP, in contrast, are to be fundamentally improved and simplified. This must occur also in view of the handling of guidelines, so that these do not jeopardize well-established and positively-evaluated healthcare programs (and along with that the quality of patient care) in the regions with well-functioning systems. In view of the persistent critiques on form and content of the state-regulated chronic-disease programs, the group "DMP in Central Germany", representing the German federal states of Saxony, SaxonyAnhalt, and Thuringia, initiated at the end of 2003 a structured survey for the evaluation of the RSA DMP Type 2 Diabetes among general practitioners and diabetes specialists. Particularly critical evaluations of the RSA DMP originate from the federal states with well-developed guideline-based diabetes care programs, for example in the new Eastern federal states, Nord Rhine-Westphalia, and Bavaria. With its minimal standards, the RSA DMP does not represent any progress in these regions and does not contribute to cost reduction. Detailed medical contents and professional guidelines do not belong to a law ordinance but to the already existing medical guidelines.