Abstract
The effects of the current hospital reform as well as the increasing shift from inpatient care to outpatient care in Germany will lead to a decline in inpatient training capacities, with the threat of current and future shortages of specialists in outpatient care. This scenario could also affect rheumatology, although the prevalence and complexity of inflammatory rheumatic diseases with systemic organ involvement make comprehensive acute inpatient rheumatology care urgently necessary. The medical, structural and training-related need for inpatient rheumatological care arises not only from the introduction of innovative treatment concepts but also in particular due to highly inflammatory and severe systemic rheumatic diseases with multiorgan involvement as well as from a wide range of comorbidities or the treatment of older people with polypharmacy multimorbidity. The planned amendment of the model advanced training regulations for rheumatism should therefore continue to take an appropriate proportion of inpatient training into account and targeted funding of specialist education is planned as part of the flat-rate payments under the Hospital Care Improvement Act (KHVVG).