Utilization of Medical Rehabilitation Services in Germany: A Comparative Analysis of Survey and Routine Data

Abstract

Population ageing leads to an increase in age-related diseases. Consequently, the need for medical rehabilitation services is also rising. Rehabilitation service in Germany is offered by several rehabilitation carriers. There is no homogeneous rehabilitation statistics, resulting in insufficient data. This paper analyses utilization of medical rehabilitation services in Germany. It uses data from a representative population-based health survey. The results were extrapolated to the general population in Germany and compared with routine data. Survey data used were those of the German Health Interview and Examination Survey for Adults (DEGS1) with 7 988 participants. Utilization rates were extrapolated to the general population. Routine data sources are the diagnostic data of the Federal Statistical Office on patients using prevention or rehabilitation facilities. Further data sources are the published statistics of the rehabilitation carriers. In order to compute the total number of rehabilitation cases, where data were lacking in the statistics of the rehabilitation carriers, an estimate was made. The analysis of the different data sources shows similar results. In 2010, there were approximately 2.2 million rehabilitation cases in Germany. Around 10% of rehabilitation measures were carried out in the ambulatory setting. Analyses of structural characteristics in the routine data are possible but not recommendable because of bias in the data. Without detailed data on age structure and trends, challenges of demographic changes and changes in the illness spectrum cannot be adequately described. Because of a lack of sufficient diagnosis-based data, statements on the appropriateness of medical rehabilitation services offered by rehabilitation carriers cannot be made.