title: No differences in post-operative rehabilitation across municipalities in patients with lumbar disc herniation.
abstract: BACKGROUND
  Following the municipal reform in Denmark in January 2007, the municipalities gained responsibility for post-operative rehabilitation. In the Region of Southern Denmark, this task was decentralised to 22 municipalities, which implied a possible risk for considerable variation. This study examined rehabilitation in the 22 municipalities of the Region of Southern Denmark for patients with lumbar disk herniation.
  
  
  METHODS
  A total of 22 physiotherapists answered a questionnaire regarding their rehabilitation programmes. The municipalities of 789 patients who had undergone decompressive surgery for lumbar disc herniation were identified. Changes in Oswestry disability index (ODI), EuroQol-5D (EQ-5D) and duration of sick leave were compared among the municipalities.
  
  
  RESULTS
  Patient-reported outcome measures showed no statistical difference in ODI, EQ-5D or sick leave at the one-year follow-up across the 22 municipalities. There was a correlation between sick leave and outcome as a longer sick leave was associated with less improvement in EQ-5D and ODI. Rehabilitation programmes across the region were comparable with respect to several factors. The questionnaire revealed a potential for enhanced cooperation between hospitals and rehabilitation centres.
  
  
  CONCLUSIONS
  Rehabilitation was broadly similar, and patient outcome after one year did not differ significantly across the 22 municipalities or between the five largest samples. In general, all municipalities request enhanced cooperation between hospital and rehabilitation unit to ensure the best possible patient treatment. Further studies should focus on the effect of rehabilitation.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Kirurgisk Sektion, Rygcenter Syddanmark, Sygehus Lillebælt, Middelfart, Østre Hougvej 55, 5500 Middelfart, Denmark. paulsenrune@hotmail.com.
authors.forename: Rune Tendal
authors.initials: RT
authors.lastname: Paulsen
authors.forename: Erik
authors.initials: E
authors.lastname: Bergholdt
authors.forename: Leah
authors.initials: L
authors.lastname: Carreon
authors.forename: Rikke
authors.initials: R
authors.lastname: Rousing
authors.forename: Karen Højmark
authors.initials: KH
authors.lastname: Hansen
authors.forename: Mikkel
authors.initials: M
authors.lastname: Andersen
mesh_terms: D002947:Cities / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003718:Denmark; D004185:Disability Evaluation; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000534:rehabilitation* / Q000601:surgery; D008159:Lumbar Vertebrae / Q000601:surgery*; D011184:Postoperative Period; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D018582:Sick Leave / Q000706:statistics & numerical data; D016896:Treatment Outcome