Concerning its clinical as well as predictive quality, the validity of SIMBO-based ratings of work-related problems has been proven. Further, it has become obvious that SIMBO is suitable as an easy-to-handle tool for identification of a need for vocationally-focused interventions for use by the social insurance agencies which finance rehabilitation. Further interesting questions arise relative to application in different indications as well as potential uses as an outcome instrument.
Return-to-work and protection of work-related participation is stated as a primary objective of rehabilitation by the statutory pension insurance institutes. A general continuous management of work-related participation in rehabilitation is a prerequisite for optimal results in view of stay in work and return to work. This means an extended vocational orientation in medical rehabilitation, individualized occupational rehabilitation according to need and capacity in connection with closer linkages between medical and occupational rehabilitation. In the course of the "Rehabilitation Sciences" research funding programme and beyond it, quite a few research projects and scientific activities aimed at development, testing and evaluation of -new screenings and diagnostic instruments with better findings of vocational related needs in medical and occupational rehabilitation, -specific methods of therapy and models for treatment settings with immediate reference to the work related restriction and capacity, as well as -models of the organization and forms of cooperation between medical and occupational rehabilitation. This paper reviews the projects and findings in these research fields in relation to the requirements for an increase of general continuous vocational orientation in rehabilitation.
Ten years after its introduction, the German Pension Insurance's quality assurance programme is firmly established within the rehabilitation system. Regular, substantive reporting to rehabilitation centres and pension insurance organisations has contributed to improving the quality of rehabilitation. Legal codification of quality assurance stipulations has existed since 2001. The programme is in constant development, e. g. by optimization of patient interviewing and inclusion of evidence-based clinical practice guidelines. New programmes, e. g. in inpatient rehabilitation of children and youths or in outpatient rehabilitation, are being developed together with the German health care organizations. In the field of vocational rehabilitation quality assurance had started out with a conceptual study followed by projects concerning client interviewing, evaluation of documentation instruments, and analyses relative to the most important outcome factor, namely the vocational reintegration results achieved. External quality assurance is a mayor input factor for the rehabilitation centres' internal quality management. In future, rehabilitation centres will be asked to demonstrate the appropriate use of this information. It will remain the centres' decision which method of quality management system implementation they choose. Quality assurance results of every centre are planned to be made publicly accessible in the medium term, in particular to the insureds. Moreover, the results of the quality assurance programmes are intended to clearly impact the allocation of patients as well as the remuneration of the rehabilitation centres concerned. Quality assurance and quality management will continue to play a major role in the political discussion of health care.
In 1998, the German Federal Ministry of Education and Research (BMBF) and the German pension insurance scheme established a funding programme for research in rehabilitation. This "Rehabilitation Sciences" research funding programme comprises eight regional research networks for eight years in two periods (1998-2002, 2001-2005). In our paper we review the findings of the first funding period in five of the research fields: patient education, need for and access to rehabilitation, vocational training in medical rehabilitation to enhance return to work, comorbid mental disorders in patients with somatic diseases, and gender differences. Several activities aimed at transferring research findings into practice are outlined. Finally, the impact of the funding programme is summarized and perspectives for further funding are given.
The programme for research in rehabilitation has been established by the Federal Ministry of Education and Research and the German Pension Insurance scheme in 1998 to further develop the methodology in this field. In addition to other effects, the large number of projects has strengthened the research structure in Germany. An important aim of the programme is the transfer of the research findings into the practice of rehabilitation. The initiators also organize this transformation process in terms of a long-term task. The paper describes the transfer of findings in the topics selected by the Pension Insurance scheme: patient education, access to rehabilitation, and vocational orientation in medical rehabilitation. Furthermore, additional activities concerning the transfer are outlined. To improve the practice of rehabilitation by transferring research findings is of great importance for the Pension Insurance scheme.
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