Jankowiak Silke, Dannenmaier Julia, Ritter Sabrina, Kaluscha Rainer, Krischak Gert
Institut für Rehabilitationsmedizinische Forschung an der Universität Ulm (IFR Ulm), Bad Buchau.
Abt. Orthopädie und Unfallchirurgie, Federseeklinik Bad Buchau.
Rehabilitation (Stuttg). 2019 Oct;58(5):312-320. doi: 10.1055/a-0801-4712. Epub 2019 Jan 23.
The aim of this study was to examine which factors predict rehabilitation setting (inpatient vs. outpatient) after hospitalization in order to indicate the meaning of severity for access to a certain kind of rehabilitation.
All patients with surgery for hip or knee (joint) endoprosthesis or disc surgery between 2005 and 2010 were selected for analysis from anonymized data from statutory health insurance (AOK Baden-Württemberg) and German Pension Fund (Bund as well as Baden-Württemberg). Logistic regression was performed for outpatient vs. inpatient rehabilitation.
Patients from all surgery groups utilize more often inpatient rehabilitation, if they started treatment immediately after hospitalization than patients that start treatment after a period at home. With increasing age as well as comorbidities patients use more inpatient rehabilitation. The probability for inpatient rehabilitation decreased between 2005 and 2009.
Beneath severity also context factors seem to be issues for the choice of inpatient or outpatient rehabilitation. For a demand-orientated access to a certain kind of rehabilitation, environmental conditions like support by family or accessibility to therapeutic, nursing or medical assistance and medical parameters like severity should be weighed against each other.
本研究旨在探讨哪些因素可预测住院后的康复环境（住院康复与门诊康复），以明确病情严重程度对于获得某种康复方式的意义。
选取2005年至2010年间接受髋关节或膝关节（关节）假体手术或椎间盘手术的所有患者，根据法定健康保险（巴登 - 符腾堡州AOK）和德国养老金基金（联邦以及巴登 - 符腾堡州）的匿名数据进行分析。对门诊康复与住院康复进行逻辑回归分析。
与在家一段时间后开始治疗的患者相比，所有手术组中那些住院后立即开始治疗的患者更常采用住院康复。随着年龄增长以及合并症增多，患者更多地采用住院康复。2005年至2009年间，住院康复的概率有所下降。
除病情严重程度外，背景因素似乎也是选择住院康复或门诊康复时需要考虑的问题。为了以需求为导向获得某种康复方式，应综合权衡家庭支持、获得治疗、护理或医疗援助的便利性等环境条件以及病情严重程度等医疗参数。
