title: [A profile of requirements for the performance of work related medical rehabilitation from the perspective of the statutory pension insurance].
abstract: OBJECTIVE
  Work-related medical rehabilitation (Work MR) is a specific part of medical rehabilitation, which is well-established and broadly investigated. In almost all indications there is evidence of benefit of Work MR in patients with distinctive work-related problems due to chronic disease or disability. Nevertheless, there is a lack of implementation in clinical practice. This is due to a variety of reasons, mainly a missing definition of the appropriate Work MR interventions. The development of a Profile of Requirements (PoR) for defining contents and patterns of Work MR on behalf of the Statutory Pension Insurance (SPI) therefore is a fundamental step towards evidence-based, needs-focused rehabilitation management. The article introduces such a PoR - for the present focused on somatic indications.
  
  
  METHODS
  The PoR was developed by an SPI expert group and revised in an extensive discourse within the SPI. A strategy involved in this context was the dissemination of work-related therapeutical concepts in medical rehabilitation.
  
  
  RESULTS
  In the PoR, Work MR is defined as a concrete work-related designing of therapeutical interventions as well as an integrated "philosophy" in thinking and practicing of the actors involved. Work MR is differentiated in 3 intervention levels: While work-related basic interventions (Level A) are provided in all facilities for all patients, core interventions (Level B) as well as specific interventions (Level C) are explicitly concentrated on patient subgroups with distinct work-related problems. In the PoR the relevant diagnostic and therapeutic work-related interventions are attributed to the different intervention levels and described concerning the concrete arrangement. The 3 central core interventions "Work-related psychological group interventions", "Work-related internal load test" and "Work conditioning" are presented.
  
  
  CONCLUSIONS
  The decisive benefit of the PoR is to substantiate the requirements of Work MR on behalf of the SPI often worded in a rather unspecific manner in the past. In the current pilot study called "Work MR Management" the feasibility of Work MR in clinical practice based on the PoR is tested. The resultant recommendations will provide the basis for disseminating Work MR throughout Germany independent of setting and indication.
authors.affiliation: Deutsche Rentenversicherung Bund, Abteilung Rehabilitation, Berlin. dr.marco.streibelt@drv-bund.de
authors.forename: M
authors.initials: M
authors.lastname: Streibelt
authors.forename: R
authors.initials: R
authors.lastname: Buschmann-Steinhage
mesh_terms: D005858:Germany; D006801:Humans; D017146:Models, Organizational; D009313:National Health Programs / Q000331:legislation & jurisprudence*; D009784:Occupational Diseases / Q000534:rehabilitation*; D009787:Occupational Medicine / Q000331:legislation & jurisprudence*; D010415:Pensions; D012046:Rehabilitation / Q000331:legislation & jurisprudence*; D012050:Rehabilitation, Vocational / Q000379:methods*