[Differential indications for ambulatory and inpatient medical rehabilitation--results of an expert survey].
Medical rehabilitation in the Federal Republic of Germany has been provided in an almost exclusively inpatient setting up to now. However, in view of an intensified development of outpatient rehabilitation programs there are new challenges to confront. As to indication criteria, new preconditions and handling directives have to be defined in order to refer patients to those rehabilitation programs from which they can profit the most. Up to now, there has been a considerable lack of knowledge as to what kind of criteria must be considered in the transfer process. The present study represents results of expert interviews (Delphi method) regarding this topic. 50 experts from inpatient and outpatient rehabilitation facilities, from the Medical Services of health insurance funds and the pension insurance system, from rehabilitation agencies as well as rehabilitation research, have been questioned since they take important stands on these questions and since their assessment has a guiding quality. An additional study had been directed at the factors which determine present decision-making in terms of inpatient vs. outpatient rehabilitation. The results show that the experts stress the importance of a multitude of different aspects; however, there still is but little consensus concerning the criteria that should invariably be considered in making these rehabilitation decisions.
Bürger
W
W
Abteilung Medizinische Psychologie am Universitätskrankenhaus Eppendorf, Hamburg. buerger@uke.uni-hamburg.de
Koch
U
U
D000328:Adult; D000553:Ambulatory Care / Q000191:economics; D003362:Cost-Benefit Analysis; D003631:Day Care, Medical / Q000191:economics; D003697:Delphi Technique; D005260:Female; D005858:Germany; D006801:Humans; D018868:Insurance, Disability / Q000191:economics; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics; D010343:Patient Admission / Q000191:economics; D018579:Patient Selection; D011785:Quality Assurance, Health Care / Q000191:economics; D012046:Rehabilitation / Q000191:economics