[Effect of Rehabilitation on the Delayed Entry into the Retirement due to Reduced Earning Capacity]. / Effekt der Rehabilitation auf den verzögerten Eintritt in die Berentung aufgrund von Erwerbsminderung.

BACKGROUND: Early retirements make up a large portion of indirect costs of illness caused by chronic back pain. METHODS: Claims data from statutory health insurance and German Pension Fund provide the basis for analysis. Cox-Regression was performed for duration to early retirement, whereby beside sociodemographic and treatment characteristics, the effect of rehabilitation was considered. RESULTS: Early retirement started on average 7.1 month later through rehabilitation. Therefore, rehabilitants made € 8,432.60 higher payments to statutory health insurance and German Pension Fund per rehabilitant. Based on the total number of 21,262 early retirees with orthopedic indications, this can save € 180.7 million. The timing of the early retirement was also affected by age and sickness benefits in the previous month. Savings by avoiding entry into early retirement have not yet been taken into account in this model. CONCLUSION: Rehabilitants receive later pensions due to reduced ability, which allow for more contributions to statutory health insurance and German Pension Fund. This indicates that medical rehabilitation is an economic and effective treatment.

[Health Economic Effects of Rehabilitation for Chronic Back Pain - An Observational Study with Combined Secondary Data from Statutory Health Insurance and German Pension Fund]. / Gesundheitsökonomische Effekte der Rehabilitation bei chronischem Rückenschmerz ­ Eine Beobachtungsstudie mittels kombinierten Sekundärdaten einer gesetzlichen Krankenkasse und der Deutschen Rentenversicherung.

BACKGROUND: Chronic back pain is the most common indication in medical rehabilitation. Numerous studies hint on positive effects of rehabilitation on health state. However, there is no evidence about the effectiveness of rehabilitation due to the lack of a valid comparison group. METHODS: Based on combined secondary data from German Pension Fund and statutory health insurance, a comparison group of insured persons was identified by their typical patient career that did not apply for rehabilitation for unclear reasons. Effectiveness was measured by direct and indirect costs of back pain between rehabilitants and non-rehabilitants. RESULTS: Costs of rehabilitation split in 2.742 € direct costs and 2.597 € indirect costs. In the 2 years following rehabilitation, rehabilitants were hospitalized less frequent and caused less indirect costs due to disability. Therefore, the benefit of rehabilitation was 727 € in the first year after rehabilitation and additional 37 € in the subsequent year. CONCLUSION: Rehabilitation for chronic back pain contributes to maintain the ability to work. Moreover, rehabilitation reduces duration of disability and healthcare utilization, hence direct and indirect costs of illness are lowered compared to a treatment without rehabilitation. Effects of rehabilitation by avoidance and delay of retirement are not yet recorded.