Article
Quality assurance in medical rehabilitative care by the German statutory pension insurance scheme
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Published: | April 16, 2019 |
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Outline
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Background: Rehabilitation services of German Pension Insurance (GPI) aim to ensure employment and participation. During 1990s, GPI initiated a quality assurance program for rehabilitation that is routine practice today.
Aim: Goal of GPI’s quality assurance program is to improve the overall quality of rehabilitation looking at structure, process, outcome and patient orientation [1]. Transparency of rehabilitative services is also of great importance. Though medical and vocational rehabilitation are addressed, here medical rehabilitation is focused.
Method: For the purposes mentioned above, the GPI has a wide range of quality assurance instruments: Specific prerequisites for structural, procedural and human resources in rehabilitation centers were defined. Standards for comprehensive rehabilitative interventions are monitored by using standardized classification codes within routine data. A peer review process of discharge letters was implemented. Patient surveys are carried out regularly. Socio-medical follow-ups up to two years after medical rehabilitation are assessed.
Results/findings: GPI finances more than 1,1 million medical rehabilitations with about 4.5 billion Euros a year. Patients suffer from chronic diseases and related disabilities, as cardiovascular or musculoskeletal diseases, tumors or mental disorders. Performing a nationwide quality assurance system is a challenge. GPI’s quality assurance results indicate effectiveness and sustainability of its medical rehabilitation services. Notable differences between facilities remain to be addressed though.
Discussion and conclusions: GPI has a comprehensive routine quality assurance program that provides a wide empirical basis. Quality improvement as well as a wide range of developments regarding medical science, society and others will have to be considered in the future.
References
- 1.
- Donabedian A. Evaluating the quality of medical care. Milbank Memorial Fund Quarterly. 1966;44:166-206.