Rehabilitation Application Rejected - What Happens Then?

Abstract

The German statutory pension insurance (Deutsche Rentenversicherung) rejects about a third of applications for medical rehabilitation. It is assumed that the health and occupational situation of people whose applications are rejected will become unsatisfactory. So far, there are no publications investigating the group of people with rejected applications. Of 2 075 included applicants, 345 persons were rejected. Patients whose applications were rejected were matched with those whose applications were approved (Propensity-Score-Matching). At the end of the study, evaluable data sets including all 3 time points of measurement (application, 4 and 10 months thereafter) were available for 173 applicants with rejected applications and for 223 applicants approved for rehabilitation. The course of development of both groups was analysed using variance analysis with repeated measurements. The study was conducted for 27 months (January 2012-March 2014). At the time of application, there were no differences in health and occupational situation between the 2 groups. Also, there were no differences between groups in their utilization of outpatient therapies in the year before their application. 4 months later, a small advantage for those with an approved application was observed, and occasionally there were even significant differences. Both groups used medical and other healthcare offers comparably frequently. 10 months after application, both groups showed further improvements. There were no differences in the number of physician or non-physician patient consultations. Our study could not confirm the assumption that the health or occupational situation of people with rejected application for rehabilitation suffers as a result of this rejection. Rather, the opposite seems to be the case. The factors that are responsible for the improvement, however, could not be identified by our study.