Maier-Riehle B, Schliehe F
Verband Deutscher Rentenversicherungsträger, Frankfurt a. M.
Rehabilitation (Stuttg). 1999 Dec;38 Suppl 2:S100-15.
The need for rehabilitation is not absolute and given quality. Determination of the need for rehabilitation depends on various criteria, e.g., the case history and certain legally standardized medical prerequisites. Both the regulation of rehabilitation expenditures and different types of personal excess coverage may be interpreted as efforts on the part of social policy to introduce additional controls (i.e., alongside the medical prerequisites) of the need for rehabilitation. Since rehabilitation benefits are only granted in case the insured has applied for, the demand for personal excess coverage might cause a certain selection of financially powerful rehabilitees. Recent cost-cutting legislation, which inter alia included strict budgeting of rehabilitation expenditures and increased personal excess coverage, had entailed a considerable decline in the number of applications for rehabilitation in 1996 and 1997. Several pension insurance funds started questioning their insured to examine the general interest in using rehabilitation services. The results show a strong need for rehabilitation in the group of the older insured (aged 40 and over), however, only 35% to 40% of the insured in subjective need for rehabilitation intend to file an application for rehabilitation and an even smaller number of insured actually apply for rehabilitation. Major impediments to applying for rehabilitation mentioned are job uncertainty as well as the increased personal excess coverage under the recent austerity legislation.
康复需求并非绝对且具有特定质量要求。康复需求的确定取决于多种标准,例如病史和某些法定标准化的医学前提条件。康复支出的规定以及不同类型的个人自负额保险都可被视为社会政策方面为引入对康复需求的额外控制(即除医学前提条件之外)所做的努力。由于康复福利仅在被保险人申请时才会发放,对个人自负额保险的需求可能会导致对经济实力较强的康复者进行某种筛选。近期的削减成本立法,其中特别包括对康复支出的严格预算编制和提高个人自负额保险,导致1996年和1997年康复申请数量大幅下降。一些养老保险基金开始询问其被保险人,以调查使用康复服务的总体意愿。结果显示,年龄较大的被保险人(40岁及以上)群体对康复有强烈需求,然而,主观上有康复需求的被保险人中只有35%至40%打算提交康复申请,实际申请康复的被保险人数量更少。提到的申请康复的主要障碍包括工作不确定性以及近期紧缩立法下增加的个人自负额保险。