There are a number of physical restrictions that develop in the course of amyotrophic lateral sclerosis (ALS). While loss of speech and motor control may be partially compensated by the support of assistive devices, swallowing difficulty and respiratory insufficiency require medical interventions (percutaneous endoscopic gastrostomy, noninvasive, and invasive ventilation). Based on the data collected within the NEEDSinALS study, we found major differences in personal satisfaction with the financing, healthcare provision, medical infrastructure, and regulations of German and Polish ALS patients, despite minor differences in economic burden caused by the disease. In order to explain this phenomenon, we thoroughly reviewed the legal basis, structure and organization of the healthcare systems in Germany and Poland to determine the range of obstacles in the everyday lives of patients and their caregivers that are attempting to attain an assistive device or care after the start of medical interventions.

在肌萎缩性侧索硬化症（ALS）的过程中，存在许多身体上的限制。辅助设备的支持可以部分弥补语言障碍和运动障碍，但吞咽困难和呼吸功能不全需要医疗干预（经皮内窥镜胃造口术，无创和有创通气）。根据NEEDSinALS研究中收集的数据，我们发现德国和波兰ALS患者在资金，医疗保健，医疗基础设施和法规方面的个人满意度存在重大差异，尽管该疾病造成的经济负担差异很小。为了解释这种现象，我们彻底审查了法律依据，