First data concerning the medical supply of patients with non-alcoholic fatty liver disease in Germany - a survey in university hospital centers of hepatology

• Published in: Zeitschrift fur Gastroenterologie Vol. 53; no. 6; p. 562
• Main Authors: Weiss, J, Rau, M, Bantel, H, Bock, H, Demir, M, Kluwe, J, Krawczyk, M, Pathil-Warth, A, Schattenberg, J M, Tacke, F, Roeb, E, Geier, A
• Format: Journal Article
• Language: German
• Published: Germany 01-06-2015
• Subjects: Gastroenterology - statistics & numerical data; Germany - epidemiology; Health Care Surveys; Hospitals, University - utilization; Humans; Non-alcoholic Fatty Liver Disease - epidemiology; Patients - statistics & numerical data; Prevalence; Referral and Consultation - utilization; Utilization Review; Workload - statistics & numerical data; Germany
• ISSN: 1439-7803
• DOI: 10.1055/s-0034-1399180

Non-alcoholic fatty liver disease (NAFLD) currently is one oft the most common reasons for chronic liver injury in the western world. In the European and American population the prevalence is up to 30 %. The medical supply of German patients with NAFLD is variable and has not been analyzed to date.
We sent questionnaires to all university liver centers in Germany (11 questions) concerning the medical supply of patients with NAFLD. Questions included the rate of patients with fatty liver disease in the outpatient clinics, metabolic comorbidities and the kind of assignment. Besides that, individual clinical standards were documented. We compared longitudinal changes between 2008 and 2013.
The return rate of questionnaires was 65 % (n = 20). Analysis showed that the portion of NAFLD patients in the university outpatient clinics had increased between 2008 and 2013 with the predominant part of patients being assigned from external practitioners and not from internal departments of the hospital. Only few patients were assigned by diabetologists or endocrinologists, but on the other hand most liver outpatient clinics investigated their NAFLD patients for metabolic disorders. Cooperation between liver outpatient clinics and other medical services was moderate and was rated average, joint conferences were held rarely. Follow-up visits of patients with NAFLD take place regularly in all centers, however based on different criterions. A consistent algorithm concerning risk assessment and invasive workup does not exist.
The awareness concerning patients with NAFLD seems to have grown in recent years. Nevertheless, the medical supply of these patients is quite heterogenous and consistent standards do not exist. Therefore, a common guidline is urgently required.