Presentation T O6

T O6 (Oral Presentation):
Access to Rehabilitation: Impact of Different Management Strategies on the Identification of Patients with Extensive Work-related Problems

Presented by: Uwe Egner

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Authors

Egner U1, Streibelt M1, Bethge M2

  1. German Federal Pension Insurance (GFPI), Department of Rehabilitation, Berlin, Germany
  2. Medical School Hannover, Department of Rehabilitation Medicine, Hannover, Germany

Abstract

Background

Work-related medical rehabilitation (WMR) has reached a substantial share in medical rehabilitation (MR) in Germany. Studies confirm higher effectiveness of WMR for patients with extensive work-related problems. Therefore, specific identification of these patients is of great importance. The question is whether different steering strategies influence the validity of the access management to WMR.

Methods

The study was focused on patients with chronic musculoskeletal diseases. Six pension insurance institutions (PI) and seven rehabilitation centres (RC) offering WMR were included. Different referral strategies concerning the place of decision (PI vs. RC) and the use of a screening (yes vs. no) were applied. The duration of sick leave and the Work Ability Score (WAI) were used to measure extensive work-related problems. Effects of the different strategies on the steering decision (WMR vs. MR) were tested in regression models.

Results

614 Patients were included in the study. Screening-based decision provided differences in times of sick leave between WMR and MR (10.8 weeks) and WAI (-5.5 pts). Decision without screening brought no significant differences. There were comparable effects concerning the place of decision (RC: 6.9 weeks; -4.2 pts; PI: 8.1 weeks; -4.5 pts).

Conclusions

The results show the positive impact of a screening based steering strategy. The place of decision (PI as well as RC) didn’t influence the quality of decision.

Schedule Details

Tuesday September 30
10:45 - 12:15 Morning Concurrent Sessions (T O1 - T O12 and Seminar 4)
Session: Healthcare providers’ interventions II
Room B