The results provide an indication of higher severity of patients in group "postoperative rehabilitation without a period at home". Nevertheless there are some indications for under-utilization of certain patient groups.
The results of this survey indicate that the characteristic of the patients is an important factor for the recommendation of SOR. Additionally the rehabilitation centers themselves have an influence on the recommendation of SOR. The results point to the fact that the rehabilitation centers use different criteria by making a recommendation.
The aim of this study was to identify relevant factors that influence utilization and interim period between hospitalization and postoperative rehabilitation after disk surgery. Logistic regression was performed for utilization of an early postoperative rehabilitation and for an interim period, when patients were going to a rehabilitation facility (directly after hospitalization or after a period at home) on claims data from statutory pension insurance and statutory health insurance. Increased utilization of postoperative rehabilitation was found in older and German patients. Moreover, adiposity and additional physiotherapy in hospital increased the utilization of postoperative rehabilitation, while blood transfusion during hospitalization was an inhibiting factor.Female gender, older age and additional physiotherapy in hospital decreased the probability for an interim period between hospitalization and postoperative rehabilitation. However, the probability for an interim period increased from 2005 to 2010. Utilization and interim period between hospitalization and postoperative rehabilitation meet patient's needs and seem adequate. Nevertheless, there are indications for under-utilization of certain patient groups (foreign citizens, unemployed persons, male patients).
The aim was to investigate the predictive value of the employment status measured in the 6, 12, 18 and 24 month after medical rehabilitation for long-term employment trajectories during 4 years. A retrospective study was conducted based on a 20%-sample of all patients receiving inpatient rehabilitation funded by the German pension fund. Patients aged<62 years who were treated due to musculoskeletal, cardiovascular or psychosomatic disorders during the years 2002-2005 were included and followed for 4 consecutive years. The predictive value of the employment status in 4 predefined months after discharge (6, 12, 18 and 24 month), for the total number of months in employment in 4 years following rehabilitative treatment was analyzed using multiple linear regression. Per time point, separate regression analyses were conducted, including the employment status (employed vs. unemployed) at the respective point in time as explanatory variable, besides a standard set of additional prognostic variables. A total of 252 591 patients were eligible for study inclusion. The level of explained variance of the regression models increased with the point in time used to measure the employment status, included as explanatory variable. Overall the R²-measure increased by 30% from the regression model that included the employment status in the 6 month (R²=0.60) to the model that included the work status in the 24 month (R²=0.78). The degree of accuracy in the prognosis of long-term employment biographies increases with the point in time used to measure employment in the first 2 years following rehabilitation. These findings should be taken into consideration for the predefinition of time points used to measure the employment status in future studies.
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