[Strategies for classification of rehabilitation clinics based on structural equality]. / Strategien zur Taxonomie von Rehabilitationskliniken auf der Basis von Strukturgleichheit.

Comparison between clinics is a basic part of most quality assurance programmes. The classification of structurally similar clinics is a prerequisite for enabling comparisons between clinics according to quality criteria. As a part of the programme point 1 "structural quality" of the Pension insurance quality assurance programme in medical rehabilitation, a procedure was developed to classify clinics into structurally similar groups. For this purpose the data of the structure survey of the quality assurance programme was used. The first step was to check whether existing classification systems could be used, which made the need for a new classification procedure apparent. The 942 participating clinics were clustered according to a successive differentiation system employing only quality-neutral criteria, e.g., the indication group, the number of different indications, the part of AHB, number of beds, and the therapeutic focus. Further differentiation beyond indication group was necessary for the indications orthopaedics, cardiology, psychosomatics, addiction and neurology. The procedure is demonstrated using the indications orthopaedics and cardiology as examples.

[Concept definition in medical rehabilitation: an instrument for quality assurance]. / Konzepterfassung in der medizinischen Rehabilitation: Ein Instrument der Qualitätssicherung.

A survey of organizational aspects of rehabilitation clinics was part of the Pension Insurance quality assurance programme in medical rehabilitation. The goal of this survey was to strengthen the awareness for these organizational dimensions and to initiate discussion with the goal of optimizing the efficiency of the clinical working process. For the structured description of various conceptual aspects a questionnaire "Dokumentationsbogen-Konzepte" was developed and its appropriateness for the indication groups orthopaedics, cardiology and psychosomatics was examined. The focus of this examination was development of different possibilities to give feedback to the clinics. The questionnaire was appropriate for the description of conceptual aspects. Differences both between and within the indication groups were discovered. The instrument can be used in the quality assurance process.

[Interdisciplinary treatment of erectile dysfunction]. / Interdisziplinäre Behandlung der erektilen Dysfunktion.

On the basis of 18 months of cooperation between the psychiatric department and the urological department of the medical hospital of the Lübeck University, a model showing how men with erectile dysfunction can receive improved aid with respect to a multidimensional diagnostic evaluation and therapy, is presented. First, the present state of the somatic-urological examination procedures is outlined, and, in the appendix, summarised in the form of checklists. The possibilities of somatic treatment are the described. In the psychiatric-psychotherapeutic section, sexual counselling and couple psychotherapy are briefly considered under the aspect of intra-psychic and interactional causes. Provided that a cooperative sexual partner is available, it is then urged that invasive treatment methods be replaced by couple therapy, and that treatment of erectile dysfunction should not be considered merely a technical repair job.