Hierarchical multi-step intervention on the skin: Practical implementation from the dermatological aspect [Stufenverfahren Haut: Praktische Umsetzung aus Dermatologischer Sicht]

Abstract

Occupational dermatoses account for over one quarter of all suspected occupational diseases notified in Germany. In an attempt to improve the care available for these, since 2005 approaches to their prevention have been further developed and integrated. The improved dermatologist's report allows early interdisciplinary prevention work in out-patients and provides for information flow among all concerned. In parallel with its introduction, the statutory employers' liability insurance associations have expanded the network of training courses. At the same time, provision has been made for patients with severe occupational dermatoses for which out-patient treatment is inadequate to be treated in specialist in-patient centres where they are treated by interdisciplinary teams and receive tailored therapy and also the best possible preventive treatment. To improve the administration within the statutory accident insurance, the hierarchical multi-step intervention approach to dermatological conditions has been introduced. It ensures that dermatology patients with occupational dermatoses can be allocated to the preventive treatments available quickly and in a manner appropriate to the stage of their condition. The overall concept is an important step in the direction of modern disease management in occupational dermatology and can be seen as a model of functioning integrated care that could be applied in other occupational illnesses. © 2007 Springer Medizin Verlag.