Unterscheiden sich ambulante und stationäre onkologische Rehabilitationsmaßnahmen im Hinblick auf Leistungserbringung und Erfolg? Eine Analyse der medizinischen Entlassungsberichte

Abstract

PURPOSE: To examine the interventions applied as well as the efficacy of outpatient and inpatient cancer rehabilitation programs on health-related parameters. MATERIALS AND METHODS: The analyses involved a sample of n=88 outpatient and n=151 inpatient cancer patients conducted as part of a main study evaluating outpatient cancer rehabilitation programs in Germany. All patients participated in a rehabilitation program on average 4 weeks after primary treatment. Medical discharge summaries represented the databasis for statistical analyses. The inpatient sample was selected according age, sex and cancer diagnosis of the outpatient sample. Interventions were assessed by the Classification of Therapeutic Procedures (KTL). Rehabilitation programs' efficacy was measured by physicians' evaluation of patients' acheivement of the initially defined rehabilitation goals. RESULTS: Significantly more patients of the inpatient group suffer from additional chronical diseases as hypertension or diabetes. These patients moreover show higher levels of distress than the outpatient sample who suffer to a greater extent from physically impairements caused by their cancer. Active treatment procedures such as physiotherapy or sports were provided more often during outpatient rehabilitation whereas the inpatient sample received more often massages, thermo-, hydro- or balneotherapies. Few significant correlations between functional disabilities and received therapeutic procedures were found. At the end of rehabilitation programs most patients of both groups have achieved their rehabilitation goals particularly with regard to the improvement of their physical functioning. CONCLUSIONS: Results indicate that from the physicians’ point of view an outpatient cancer rehabilitation program may be an effective alternative treatment to inpatient programs for specific groups of patients. However, interventions do more reflect specific clinic concepts rather than to be tailored to patients’ specific impairments.