German Parkinson’s network as a scalable approach for integrated care in daily medical routine

Abstract

Due to the sectoral boundaries of the German healthcare system, a lack of interdisciplinary cooperation is evident. As a result, patients are either under-supplied or incorrectly treated. Mainly initiated by regional players, health care networks help to overcome local deficits in care. The core element of health care networks is the inclusion of all health care providers in the patient-centered treatment as well as a strengthened exchange of experiences and knowledge.
 Parkinson's disease (PD) is a neurodegenerative disorder, with a chronic progressive disease course divided into different stages. It is the second most common neurodegenerative disease with the fastest increase in the number of people affected of all neurological disorders worldwide. PD is considered as a model condition for the implementation of innovative healthcare concepts in chronic neurological diseases. For adequate healthcare and an optimized support, a multidisciplinary approach is necessary, considering the individual needs as well as the complexity of PD with its various motor and non-motor symptoms.
 Based on the findings of recent research projects, especially from the Dutch ParkinsonNET, several regional network structures for PD have been established in Germany in the past five years. Meanwhile, the German care landscape includes more than ten regional PD health care networks. In 2022, the “German PD network” has been founded as an umbrella organization.
 The overall goal of the umbrella organization is to provide PD patients in Germany with nationwide access to the networked structures described above. To ensure such universal access, data from international experiences as well as from Germany demonstrate that a coordinating institution is indispensable. The coordinating institution (networking centre) is responsible for the daily and practical integration of the PD patients into the network as well as for the maintenance and further development of the networks. Scientific evidence for the effects of PD networks is widely available , therefore the goal of the German PD network is to reach the financial support of network structures by statutory health insurance, while evaluation the structures on an ongoing basis. Therefore, the German PD network designs structures, such as a digital care path, to create an integrated and coordinated care concept for PD patients which then can be transmitted to further neurological diseases.
 Challenges in PD healthcare routines are targeted using multidisciplinary care networks. Scientific evidence shows clear effects of PD network structures evolving in a strengthened intra- and interdisciplinary communication as well as greater and improved treatment coordination. Simultaneously, increased coordination leads to a reduction in the use of resources and mortality, a higher health-related quality of life as well as self-management for PD patients. Support and active participation in the development process of PD networks by the statutory health insurance is sought as a next step.