title: [Exploration of Problem Patterns in Orthopedic Medical Rehabilitation on Behalf of the German Pension Insurance to Improve Access Management and Treatment Adequacy].
abstract: OBJECTIVE
  To explore problem patterns of patients with musculoskeletal disorders assigned to and treated with a conventional (CR), behavioural-medical (BMR) or work-related (WR) rehabilitation concept.
  
  
  METHODS
  We conducted interviews with 8 patients per concept, focus groups with 2 rehabilitation teams and 1 focus group with socio-medical assessors. For the interviews patients with chronic back pain were included, receiving inpatient rehabilitation. Data was examined by qualitative content analysis.
  
  
  RESULTS
  We identified 7 problem patterns (one typical for patients in CR, 3 typical for specified subgroups in BMR resp. WR), differing in psychological co-morbidity, limitations of work-related activities and participation, psychosocial stress and pain. On the basis of detailed characterizations of these patterns, we developed recommendations for access and treatment management.
  
  
  CONCLUSIONS
  The study specifies and demarcates different problem patterns in orthopedic rehabilitation and, therefore helps to further improve access management and treatment adequacy. Future studies should verify the generated findings on representative samples.
authors.affiliation: Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck.
authors.forename: B
authors.initials: B
authors.lastname: Schwarz
mesh_terms: D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009313:National Health Programs / Q000458:organization & administration; D019637:Orthopedic Procedures / Q000534:rehabilitation*; D010146:Pain / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010358:Patient Participation / Q000523:psychology*; D058996:Quality Improvement; D013315:Stress, Psychological / Q000523:psychology*