[Quality profile of a rehabilitation clinic for natural healing methods--Part 2: Patient and outcome profile].
OBJECTIVE
To present a patient care evaluation program exemplified by a rehabilitation clinic for complementary and alternative medicine(CAM) with emphasis on the description of patients and the outcome quality of the facility.


METHODS
Prospective cohort study on all patients admitted to the hospital over a period of 2 years; physician's questionnaire to assess basic medical data, and patients'questionnaires at admission and at discharge from hospital completed by 3 follow-up queries (at 2, 6, and 12 months after discharge)to assess severity of complaints, health related quality of life, health behavior, demand of medical services, days off work,and patient satisfaction. At the beginning of the intervention, sociodemographic status, basic medical data, experience with CAM and expectations with regard to treatment success were documented.


RESULTS
5,278 patients (83% female, age 54.7+/-11.6 years)with diagnoses mainly out of the domains 'Chronic fatigue' (36.8%), 'Chronic back pain' (19.5%) and 'Chronic headache' (11.9%) were included into the analysis (follow-up return rate 80.6% after 6 months, 73.6% after 12 months). Complaints had persisted for 6 years (median). The intensity of the main complaint decreased from 59+/-25 by an average of 25 points at discharge (19 points at 6-month follow-up) corresponding to an effect size of 0.86 (0.62 at 6-month follow-up). At 6-month follow-up about half of the patients showed a clinically relevant improvement of quality of life (SF-36 sum scores increased by >or=5 points). Intake of drugs was reduced,the number of days off work had decreased after rehabilitation. Patients' satisfaction was 'good' on average, with respect to food satisfaction it was lower. A subgroup analysis regarding the principal diagnosis revealed different emphases in outcome profiles.


CONCLUSIONS
The patients profile underlines the need of inpatient rehabilitative treatment resembling other patients in CAM care. The outcome profile proved by a representative sample that the majority of patients benefited from rehabilitation with respect to various outcome dimensions at that this benefit still persisted after 6-12 months.
Weidenhammer
Wolfgang
W
Zentrum für naturheilkundliche Forschung, II. Med. Klinik und Poliklinik, TU München, Germany. Wolfgang.Weidenhammer@lrz.tu-muenchen.de
Wessel
Anne
A
Melchart
Dieter
D
D000328:Adult; D000368:Aged; D001416:Back Pain / Q000628:therapy*; D015331:Cohort Studies; D000529:Complementary Therapies / Q000379:methods* / Q000592:standards; D015673:Fatigue Syndrome, Chronic / Q000628:therapy*; D005260:Female; D020773:Headache Disorders / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D012047:Rehabilitation Centers / Q000592:standards* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome