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[Practice guidelines in rehabilitation: infringement upon physicians' autonomy or foundation for better outcomes?].
Rehabilitation (Stuttg). 2004 Oct; 43(5):304-11.R

Abstract

Clinical practice guidelines - seen as an aggregation of scientific evidence - and evidence based medicine are of relevance and importance for everybody involved in health care. Nevertheless, the discussion of their pros and cons is controversial. Major criticisms concern methodological aspects, a disregard of the patients' perspective, potentially increasing costs and the limitation of doctors' autonomy possibly caused by streamlining therapy. Supporters emphasize the improvement of care that comes with using proven therapies, patients' empowerment, cost reduction and equity in the distribution of resources. Following medical practice guidelines the liability for medical malpractice may be limited, but non-adherence to guidelines does not entail liability per se. Clinical practice guidelines in the rehabilitative sector differ from those in curative medicine by being required to achieve more complex goals than maintenance, recovery and improvement of health. Activities in the rehabilitation sector address two main topics: The integration of rehabilitation into curative guidelines, e. g. by participating in the German clearing process for guidelines, and the development of guidelines specific to rehabilitation. There are a number of guideline initiatives, e. g. with the Association of the Scientific Medical Societies (AWMF), the Federation of German Pension Insurance Institutes (VDR) and the Federal Insurance Institute for Salaried Employees (BfA). The BfA project is the first to allow integration of evidence based medicine into the quality assurance programme of the German Pension Insurance complementing it with differentiated criteria for the assessment of therapeutic processes. Taking evidence based medicine increasingly into consideration and the continuous process of introducing rehabilitative clinical practice guidelines are going to improve health care for people with chronic diseases.

Authors+Show Affiliations

Bundesversicherungsanstalt für Angestellte, Berlin. dr.silke.brueggemann@bfa.deNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

ger

PubMed ID

15472789

Citation

Brüggemann, S, and C Korsukéwitz. "[Practice Guidelines in Rehabilitation: Infringement Upon Physicians' Autonomy or Foundation for Better Outcomes?]." Die Rehabilitation, vol. 43, no. 5, 2004, pp. 304-11.
Brüggemann S, Korsukéwitz C. [Practice guidelines in rehabilitation: infringement upon physicians' autonomy or foundation for better outcomes?]. Rehabilitation (Stuttg). 2004;43(5):304-11.
Brüggemann, S., & Korsukéwitz, C. (2004). [Practice guidelines in rehabilitation: infringement upon physicians' autonomy or foundation for better outcomes?]. Die Rehabilitation, 43(5), 304-11.
Brüggemann S, Korsukéwitz C. [Practice Guidelines in Rehabilitation: Infringement Upon Physicians' Autonomy or Foundation for Better Outcomes?]. Rehabilitation (Stuttg). 2004;43(5):304-11. PubMed PMID: 15472789.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Practice guidelines in rehabilitation: infringement upon physicians' autonomy or foundation for better outcomes?]. AU - Brüggemann,S, AU - Korsukéwitz,C, PY - 2004/10/9/pubmed PY - 2005/1/29/medline PY - 2004/10/9/entrez SP - 304 EP - 11 JF - Die Rehabilitation JO - Rehabilitation (Stuttg) VL - 43 IS - 5 N2 - Clinical practice guidelines - seen as an aggregation of scientific evidence - and evidence based medicine are of relevance and importance for everybody involved in health care. Nevertheless, the discussion of their pros and cons is controversial. Major criticisms concern methodological aspects, a disregard of the patients' perspective, potentially increasing costs and the limitation of doctors' autonomy possibly caused by streamlining therapy. Supporters emphasize the improvement of care that comes with using proven therapies, patients' empowerment, cost reduction and equity in the distribution of resources. Following medical practice guidelines the liability for medical malpractice may be limited, but non-adherence to guidelines does not entail liability per se. Clinical practice guidelines in the rehabilitative sector differ from those in curative medicine by being required to achieve more complex goals than maintenance, recovery and improvement of health. Activities in the rehabilitation sector address two main topics: The integration of rehabilitation into curative guidelines, e. g. by participating in the German clearing process for guidelines, and the development of guidelines specific to rehabilitation. There are a number of guideline initiatives, e. g. with the Association of the Scientific Medical Societies (AWMF), the Federation of German Pension Insurance Institutes (VDR) and the Federal Insurance Institute for Salaried Employees (BfA). The BfA project is the first to allow integration of evidence based medicine into the quality assurance programme of the German Pension Insurance complementing it with differentiated criteria for the assessment of therapeutic processes. Taking evidence based medicine increasingly into consideration and the continuous process of introducing rehabilitative clinical practice guidelines are going to improve health care for people with chronic diseases. SN - 0034-3536 UR - https://www.unboundmedicine.com/medline/citation/15472789/[Practice_guidelines_in_rehabilitation:_infringement_upon_physicians'_autonomy_or_foundation_for_better_outcomes]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2004-828434 DB - PRIME DP - Unbound Medicine ER -