[Rehabilitation of severely injured patients in acute care hospitals: who is doing what? A nationwide survey in the Trauma Network DGU].
BACKGROUND
During the treatment of severely injured patients, rehabilitation takes an important role. In this study we examined the present structures in acute care hospitals, which influence the process of rehabiliation.


METHODS
The data was captured in a questionnaire. The questions deal with the personal and structural situation of acute care hospitals in Germany. The questionnaires were sent to all clinics, which are registered in the TraumaNetwork DGU.


RESULTS
424 hospitals answered the questionnaire. This is a response rate of 57.3% regarding 740 acitve clinics in the TraumaNetwork DGU. 58% have no opportunity for rehabilitation. The majority of the hospitals have a physiotherapy, (98.6%) or an occupational therapy (71.0%); 33.3% have a case management. Only 17.0% of the hospitals have rehabilitation teams which take care during the hospital stay. These teams consist mainly of internal rehabilitation physicians and physical therapists. Supraregional Trauma Center have better organized structures, as hospitals with lower level of care. Only 56.6% of all hospitals reported that they were familiar with the cooperating rehabilitation hospitals. There are special cooperations with rehabilita­tion hospitals in 34.4% of all cases.


CONCLUSIONS
The early mobilisation of severely injured patients is an integral part of the postoperative course in German hospitals. While on the one hand a large number of hospitals have good structural conditions on the other hand these structures are little integrated in the daily treamtment. There are major gaps and uncertainties in the cooperation between acute care clincs and rehabilitation hospitals. The integra­tion of rehabilitation hospitals in the TraumaNetwork DGU could be a good chance to improve this collaboration.
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Gießen und Marburg, Standort Marburg.
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Debus
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Gießen und Marburg, Standort Marburg.
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Mierswa
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Gießen und Marburg, Standort Marburg.
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Ruchholtz
Klinik für Visceral-, Throrax- und Gefäßchirurgie, Universitätsklinikum Gießen und Marburg, Standort Marburg.
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Lopez
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Gießen und Marburg, Standort Marburg.
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Schwarting
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Gießen und Marburg, Standort Marburg.
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CA
Kühne
D000208:Acute Disease; D000328:Adult; D000368:Aged; D019090:Case Management / Q000706:statistics & numerical data*; D019058:Community Networks / Q000706:statistics & numerical data*; D003422:Critical Care / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010360:Patient Transfer / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D014193:Trauma Centers / Q000706:statistics & numerical data*; D015599:Trauma Severity Indices; D014194:Traumatology / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000534:rehabilitation*; D055815:Young Adult