[Modern concepts of medical care--what has been achieved by the implementation of disease management programs?].

Since 2003, structured treatment programs for chronically ill patients (disease management programs; DMPs) have been under development in Germany. Virtually nationwide, programs in which physicians and patients can register are being offered for diabetes mellitus types 1 and 2, breast cancer, coronary heart disease and asthma/COPD. The medical content of the programs is determined on the basis of evidence-based medicine. Even though the effectiveness of structured treatment programs is documented for diabetes, adequate studies confirming the overall transferability of results to the German health care system are as yet lacking. Physicians above all strongly criticise the coupling of DMPs with the risk adjustment scheme of the statutory health insurance funds, as well as the large amount of paperwork involved.