["Who profits?" - patient characteristics as outcome predictors in psychosomatic rehabilitation].
The study was to examine how far treatment success in psychosomatic rehabilitation can be predicted from patients' characteristics. The aim of this study included the development of outcome criteria, the analysis of bivariate correlations, as well as development and examination of multivariate models. The motivation for dealing with job-related problems was evaluated separately. Data were available from admission, discharge and three-months follow-up. The data of 463 patients were included. Generated were success criteria concerning sociomedical development, health as well as the ability to work. All success criteria were dichotomized. In the criteria defined, successful outcomes were found in 40 to 60% of the patients. In the bivariate analyses, it was shown that many sick days before rehabilitation, applications for pension, severe disability, high impairment, and suggestion for rehabilitation by the insurance agency, have basically negative effects on success. Correlations with the variables concerning motivation for dealing with job-related problems were rather weak. In multivariate model development, models of different quality were found. For prediction of working ability at discharge, there was an explained variance of nearly 60%. In the other success criteria as well, explained variance amounted to over 20%. The models consist of different constellations of variables, the number of sick days before rehabilitation, variables of application for pension and severity of the impairment frequently included. In case of a current sick leave, rehabilitation should be started early, sociomedical problems have to be dealt with explicitly, and rehabilitation should be accompanied by preparatory and aftercare measures.
Oster
J
J
Universitätsklinik für Psychosomatische Medizin und Psychotherapie, Ulm. joerg.oster@uni-ulm.de
Müller
G
G
Wietersheim
J von
Jv
D000203:Activities of Daily Living / Q000145:classification*; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D004185:Disability Evaluation; D004608:Eligibility Determination / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D006801:Humans; D055809:Illness Behavior; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009042:Motivation; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011379:Prognosis; D011602:Psychophysiologic Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D012050:Rehabilitation, Vocational / Q000706:statistics & numerical data*; D018582:Sick Leave / Q000706:statistics & numerical data; D012943:Social Security / Q000706:statistics & numerical data; D013223:Statistics as Topic; D011795:Surveys and Questionnaires