Inanspruchnahme einer Anschlussrehabilitation nach orthopädischer Operation – Beeinflusst die Fallschwere das Rehabilitationssetting (ambulant vs. stationär)?

Abstract

The aim of this study was to examine which factors predict rehabilitation setting (inpatient vs. outpatient) after hospitalization in order to indicate the meaning of severity for access to a certain kind of rehabilitation. All patients with surgery for hip or knee (joint) endoprosthesis or disc surgery between 2005 and 2010 were selected for analysis from anonymized data from statutory health insurance (AOK Baden-Württemberg) and German Pension Fund (Bund as well as Baden-Württemberg). Logistic regression was performed for outpatient vs. inpatient rehabilitation. Patients from all surgery groups utilize more often inpatient rehabilitation, if they started treatment immediately after hospitalization than patients that start treatment after a period at home. With increasing age as well as comorbidities patients use more inpatient rehabilitation. The probability for inpatient rehabilitation decreased between 2005 and 2009. Beneath severity also context factors seem to be issues for the choice of inpatient or outpatient rehabilitation. For a demand-orientated access to a certain kind of rehabilitation, environmental conditions like support by family or accessibility to therapeutic, nursing or medical assistance and medical parameters like severity should be weighed against each other.