[Is the guideline for work-related medical rehabilitation successfully implemented?]. / Gelingt die Umsetzung des Anforderungsprofils zur Durchführung der medizinisch-beruflich orientierten Rehabilitation?

ABSTRACT

BACKGROUND: The guideline for work-related medical rehabilitation (WMR) in responsibility of the German Pension Insurance describes standards of work-related measures in medical rehabilitation. We investigated if contents and recommended amount of treatment were successfully implemented and which improvements were associated with the implementation. METHODS: Implementation of the WMR guideline was evaluated at 7 inpatient orthopaedic rehabilitation centres. Patients completed questionnaires at beginning of rehabilitation, at dis-charge and 3 months after discharge. Details -regarding the treatments provided were extracted from the standardised discharge report. RESULTS: The recommended amount of social counselling and work-related psychosocial therapy measures were appropriate. However, there were discrepancies regarding the recommended amount of functional capacity training. The standardised mean difference (SMD) between baseline and 3-month follow-up sick leave duration indicated an almost medium-sized effect (SMD=0.47; 95% CI 0.28-0.66). An additional 5 h of work-related therapy was associated with a 1.2-week decrease in sick leave duration (95% CI -2.38 to -0.03). CONCLUSION: The guideline was for the most part successfully implemented and sets important standards for the roll-out of WMR. The nationwide implementation of the WMR guideline requires a continuous quality assurance that -enables promptly feedback about the achieved implementation level.