Inanspruchnahme medizinischer rehabilitation

In Germany, the Pension Insurers Institutions provide for medical rehabilitation measures of workmen and salaried employees. The measures intend to prevent early retirement caused by illhealth. It is questionable, if selection of rehabilitation participants is based on needs. Experts estimate the range of over-utilization close to 30 %. We tried to establish empirical evidence for the estimated range of over-utilization. Investigations were part of a demonstration project that developed and tested a screening process of early medical rehabilitation intervention in persons insured with a specific Pension Insurer Institution. For 53 persons participating in medical rehabilitation measures in the demonstration project a second evaluation at the beginning of treatment in the rehabilitation clinic was effectuated. Physicians of the rehabilitation clinics evaluated persons according to the same procedures the general pratitioners (GPs) had used. The Pension Insurer Institution uses evaluation of GPs as a basis for the accreditation of rehabilitation measures. The first and second evaluation were compared for diagnoses and assessments of work capacity either reduced or at risk. The second evaluation confirmed the GPs main diagnosis in 66 % of the cases. In contrary, no indication for rehabilitation measures existed in light of the second evaluations for 33 % of the participants in rehabilitation measures because their work capacity was neither substantially at risk nor reduced, and did not fulfill the existing requirements for the accreditation of rehabilitation measures. Investigations confirmed the thesis of overutilization of rehabilitation measures and its range. Criteria for the accreditation of rehabilitation measures must be improved