Acura Rheumatism Center Baden-Baden

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Acura Rheumatism Center Baden-Baden
logo
Sponsorship Acura Kliniken Holding GmbH
place Baden-Baden
Coordinates 48 ° 45 '52 "  N , 8 ° 14' 50"  E Coordinates: 48 ° 45 '52 "  N , 8 ° 14' 50"  E
management Nikolaus Miehle (Chief Physician)
Care level Main focus supply
beds 132
Employee 150
including doctors 13
areas of expertise Internal medicine / rheumatology
founding 1890
Website acura-kliniken.com

The ACURA Rheumazentrum Baden-Baden is part of Acura-Kliniken GmbH and is an acute hospital for internal medicine / rheumatology in the Association of Acute Rheumatology Clinics (VRA). The clinic is an academic teaching hospital and has been a cooperation clinic of Heidelberg University Hospital since 2004 .

history

In 1890, the Landesbad Baden-Baden was founded as the forerunner of today's Acura Rheumatism Center Baden-Baden. At the location of the first clinic building in the bathing district of the city of Baden-Baden and in the immediate vicinity of the Roman bath ruins, the so-called poor bath had been located since the Middle Ages. The clinic was enlarged with several extensions in 1910 and 1938 and was - with the exception of its use as a military hospital during the wars - a center for balneology (spa medicine).

Treatment of patients in the Landesbad Baden around 1915

In the 1960s, the clinic focused more and more on the treatment of patients with rheumatic diseases.

In 1979 a modern new building was built with 2-bed rooms and departments for diagnostics and occupational therapy . Under the leadership of the then medical director Martin Franke and his successor Ernst-Martin Lemmel, the clinic, which since then has also been an academic teaching hospital of the University of Heidelberg, became one of the leading German acute rheumatic hospitals for internal rheumatology and physical therapy ("Staatliches Rheumakrankenhaus Baden-Baden") . The state of Baden-Württemberg sold the clinic to hospital entrepreneur Rüdiger Hurrle in 1997 , and the clinic has operated as Rheumazentrum Baden-Baden GmbH since then.

In 2003, the first cooperation agreement with the Heidelberg University Hospital and the establishment of the Psychosomatic Clinic in the Rheumatism Center Baden-Baden with the Medical Director Wolfgang Eich took place. In a second cooperation agreement, Christoph Fiehn was appointed head physician at the Rheumatism Center in 2004 and, with the support of the Rheumatology Center Baden-Baden, a rheumatology section was established at the Heidelberg University Hospital. Its director, Hanns-Martin Lorenz, was also appointed medical and scientific director of the Baden-Baden Rheumatism Center. An interdisciplinary ward for rheumatology and the psychosomatic clinic (“interdisciplinary pain ward”), mainly for patients with fibromyalgia , was founded. The clinic was expanded into an outpatient center with the integration of up to six specialist practices in the building and, in 2006, the establishment of a medical care center (MVZ) with the addition of another four practices.

During these years, the clinic's scientific orientation was strengthened with the establishment of an outpatient clinic for clinical studies and the publication of a large number of scientific papers in international journals and book contributions, especially on the subject of rheumatoid arthritis therapy with biologics and methotrexate .

In 2008 the clinic was sold to Acura Kliniken Holding GmbH.

In 2009 a magnetic resonance tomograph (MRT) and a computer tomograph (CT) were installed in the radiology practice attached to the clinic. In addition, in 2010 an in-patient outpatient clinic for rheumatology was established as a supplement to the previously existing advisory outpatient clinic for patients with statutory health insurance. After all, the clinic had a child and adolescent rheumatology section from April 2014 to 2016.

These infrastructural improvements, the growing scientific reputation and the changeover to the new flat-rate hospital financing ( DRG ) 2004-2006 strengthened the importance of the Rheumazentrum Baden-Baden as an acute rheumatological hospital in Germany.

architecture

Postcard view of the Baden state spa around 1900

The clinic was built in three major construction phases in Baden-Baden . The building erected in 1890 by Josef Durm in the founder style is at the center of the complex. To the east, in the vicinity of the Caracalla Therme, is the extension from 1938, which today houses the psychosomatic clinic. The main bed wing of the rheumatism center was built in 1979 to the west of the Rotenbachtal.

Bed wing of the Acura Rheumatism Center Baden-Baden in 2009

Medical orientation

Multimodal rheumatological complex treatment

The interdisciplinary therapy of patients with severe rheumatological diseases, especially rheumatoid arthritis, has been the most important medical focus of the clinic since the establishment of the acute rheumatic hospital in 1979 and was significantly developed in Baden-Baden (Lakomek et al. 2002). In addition to drug therapy, this includes physiotherapy and physical medicine , occupational therapy and clinical psychology as well as close cooperation with other medical specialties such as B. orthopedics , hand surgery , angiology and many more as part of an inpatient treatment concept.

This multidisciplinary therapy is now firmly anchored in the guidelines for the treatment of rheumatoid arthritis, the most common inflammatory rheumatic disease, as well as ankylosing spondylitis . As a “multimodal rheumatological complex treatment”, this form of treatment has also found its way into the case flat-rate reimbursement catalog (DRG) for inpatient treatment. Since the introduction of the DRG in 2006, the Acura Rheumatism Center Baden-Baden has carried out this multimodal rheumatological complex treatment in> 50% of inpatients and, in addition, a gerontorheumatological complex treatment in around 5% of patients. All of these forms of therapy are based on the multidisciplinary, i.e. H. Interdisciplinary treatment of patients with severe rheumatic diseases in the respective adaptation to the different age groups.

Biologics and disease modifying antirheumatic drugs (DMARD)

In the last decade the research and establishment of modern therapy strategies, especially with biologics (e.g. TNF-alpha inhibitors and others) for the treatment of rheumatoid arthritis and other inflammatory rheumatic diseases such as systemic lupus erythematosus (SLE), have been added . Milestones were the establishment of an outpatient clinic for clinical studies at the Acura Rheumatism Center Baden-Baden in 2005 at the z. B. approval studies for the biological drug tocilizumab have been carried out, as well as various scientific publications z. B. to rituximab or albumin-coupled methotrexate as a further development of the most important basic drug (disease modifying antirheumatic drug = DMARD ) for the treatment of rheumatoid arthritis.

Focus of the Acura Rheumatism Center Baden-Baden

Quality projects, awards and external funding

The rheumatism center has been participating in the benchmarking quality project obra ( outcome benchmarking rheumatological acute clinics) (see: project report obra ) of the Association of rheumatological acute clinics (VRA) since 2004 . In addition to regular patient surveys, measurements of the quality of results of the treatment of rheumatoid arthritis are carried out, evaluated and processed in a benchmarking process with other participating clinics. The aim is to continuously improve the quality of the participating clinics. Since 2013, the Acura Rheumatism Center Baden-Baden has had the seal of the VRA certified acute rheumatism hospital.

In 2009, the Acura Rheumatism Center Baden-Baden was the first in Germany to hold the advanced training course “Rheumatological specialist assistance - inpatient care” certified by the Rheumatology Academy of the German Society for Rheumatology . Since then, this training to become a “rheumatoid nurse” can be completed at different locations in Germany.

In 2009, a committee set up by Axel Springer Verlag selected the Acura Rheumatism Center Baden-Baden as one of the 50 best clinics in Germany (Geraedts & Stötzner). In addition, it was included in the selection list for the health quality award of the state of Baden-Württemberg in 2009. Since 2010, the Acura Rheumatism Center Baden-Baden has been funded by the Interreg program of the European Commission (“LupusBioBank des Oberrheins” project). In 2013, the Medical Director Christoph Fiehn received the Kussmaul Medal of the German Association of the Arts as a member of the Rheumatological Assistance Working Group. Society for Rheumatology for special merits in rheumatology.

numbers, data, facts

Medical directors since 1945

  • WH Fähndrich 1946-1967
  • Martin Franke 1967–1986
  • Ernst-Martin Lemmel 1986–1997
  • Bernhard Lang 1997-2003
  • Christoph Fiehn 2004-2017
  • Nikolaus Miehle since 2017
  • Employees: approx. 150 employees, including 13 doctors, approx. 60 nurses, approx. 15 physiotherapists, 4 x-ray technical assistants (RTA), 3 medical-technical assistants (MTA), 4 psychologists, 2 occupational therapists, 1 social worker
  • Number of beds (according to the state bed plan): 132 (+44 ACURA Psychosomatic Clinic)
  • Inpatient cases 2015: 2050 (+ approx. 920 ACURA Psychosomatic Clinic)
  • Multimodal complex treatments 2015 (DRG I97Z): approx. 827
  • Most common diagnosis: rheumatoid arthritis
  • Catchment area: Baden-Baden and Karlsruhe region (approx. 30%) other Baden-Württemberg (approx. 60%) and other federal states (approx. 10%)
  • Referrers: Internal rheumatologists (approx. 60%), general practitioners and internists (approx. 30%), orthopedists (approx. 10%)

Rheumatism clinic:

  • Number of cases 2015: a total of approx. 4500 patients / year

Outpatient structures:

  • Private outpatient clinic
  • Authorization outpatient clinic

Diagnostics: X-ray , sonography and Doppler sonography , echocardiography , clinical laboratory and autoimmune laboratory , bone density measurement (DXA), lung function with CO diffusion measurement (body plethysmography ), endoscopy , capillary microscopy and electrophysiology . Magnetic resonance imaging (MRI) and computed tomography (CT) in the building.

literature

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  • C. Fiehn: The future of folic acid antagonist therapy in rheumatoid arthritis. In: Arthritis & Rheumatism . 60, No. 1, 2009, pp. 1-4
  • C. Fiehn, F. Kratz, G. Sass, U. Muller-Ladner, E. Neumann: Targeted drug delivery by in vivo coupling to endogenous albumin: an albumin-binding prodrug of methotrexate (MTX) is better than MTX in the treatment of murine collagen-induced arthritis . In: Annals of the Rheumatic Disease . tape 67 , no. 8 , 2008, p. 1188-1191 , PMID 18408252 .
  • C. Fiehn: The difficult therapy decision: Rituximab for the treatment of RA patients with a high risk of infection. In: MedReview 11, No. 12, 2010, pp. 10-11 ISSN  1615-777X
  • M. Geraedts, K. Stötzner: The best hospitals in Germany In: Hörzu , No. 20/2009, pp. 7-11
  • H.-J. Lakomek, W. Fiori, K. Buscham, JL Hülsemann and N. Köneke: The multimodal rheumatological complex treatment (OPS 8-983). Challenges, solutions and perspectives . In: Journal of Rheumatology . tape 64 , no. 8 , 2005, p. 557-563 , doi : 10.1007 / s00393-005-0783-8 .
  • H.-J. Lakomek, G. Neeck, B. Lang and J. Jung: Structural quality of acute internal rheumatological clinics - project group work of the VRA . In: Journal of Rheumatology . tape 61 , no. 4 , 2002, p. 405-414 , doi : 10.1007 / s00393-002-0429-z .
  • G. Manz (Ed.): State Rheumatism Hospital Baden-Baden. Festschrift for the 100th anniversary. Self-published, Baden-Baden 1990
  • obra - Outcome benchmarking in acute rheumatological care. Project report. Schüling Verlag, Münster 2007, ISBN 978-3-86523-077-5 .
  • N. Roeder, W. Fiori, JL Hülsemann, N. Könecke and H. Lehmann: Rheumatology in the G-DRG case flat rate system . In: Journal of Rheumatology . tape 63 , no. 1 , 2004, p. 43-56 , doi : 10.1007 / s00393-004-0578-3 .
  • M. Schneider, M. Lelgemann, H.-H. Abholz: Interdisciplinary Guideline Management of Early Arthritis. Steinkopff Verlag, Darmstadt 2005, ISBN 3-7985-1497-6
  • JS Smolen, A. Beaulieu, A. Rubbert-Roth et al .: Effect of interleukin-6 receptor inhibition with tocilizumab in patients with rheumatoid arthritis (OPTION study): a double-blind, placebo-controlled, randomized trial . In: The Lancet . tape 22 , no. 371 , 2008, p. 987-997 , PMID 18358926 .

Web links

Individual evidence

  1. ↑ E-Bundesanzeiger
  2. ^ Baden-Württemberg . Association of acute rheumatology clinics
  3. ↑ Manz et al. 1990
  4. ↑ Fiehn et al. 2008 and 2009
  5. ↑ Roeder et al. 2002
  6. ↑ Schneider et al. 2005
  7. ↑ Lakomek et al. 2005
  8. ↑ Smolen et al. 2008
  9. ^ Fiehn 2010
  10. ↑ Fiehn et al. 2008 and 2009
  11. ↑ rheumaakademie.de
  12. ↑ Quality Promotion Prize ( Memento from 23 August 2010 in the Internet Archive )
  13. ↑ dgrh.de ( Memento from October 16, 2015 in the Internet Archive )