Schlöffel Malgorzata, Kampling Hanna, Fichtner Urs, Farin-Glattacker Erik, Pollmann Hartmut, Mittag Oskar
Sektion Versorgungsforschung und Rehabilitationsforschung, Universitätsklinikum Freiburg, Medizinische Fakultät der Universität Freiburg.
Klinik für Psychosomatik und Psychotherapie, Universitätsklinikum Gießen und Marburg GmbH, Gießen.
Rehabilitation (Stuttg). 2021 Aug;60(4):243-251. doi: 10.1055/a-1282-8564. Epub 2020 Nov 5.
Up to now, there has been a lack of proactive approaches on the part of the rehabilitation providers, while simultaneously a suspected unmet rehabilitation need exists in some groups of insured persons. Therefore, the effectiveness of the invitation to a web-based self-test for rehabilitation needs as a new access route to medical rehabilitation was evaluated. The main question was whether the intervention leads to more approved rehabilitation applications in the follow-up period of 22 months and whether this effect is also apparent after controlling other influencing variables.
A randomized, controlled study with N=8000 insured persons of two regional statutory pension insurance agencies was conducted to check the effectiveness of the intervention. Insured persons of the intervention group (IG; n=4000) were informed by mail about the web-based self-test and received individual access data for it (user ID and PIN). The control group (CG; n=4000) received no information about the self-test. The primary outcome was the rate of approved rehabilitation applications, the secondary outcome was the application rate regardless of approval.
Groups do not differ significantly in terms of primary or secondary outcomes. Even after controlling for other influencing factors, the intervention does not contribute to the prediction of outcomes, but some control variables, such as previous rehabilitation experience, prove to be important predictors for the application.
The mere offer of a self-test for rehabilitation need by the pension insurance institution has no effect on the application process. Hence a letter from the pension insurance institution as the sole means of access does not appear suitable for increasing the rate of meaningful rehabilitation applications.
到目前为止,康复服务提供者缺乏积极主动的方法,与此同时,一些被保险人群体中存在未得到满足的康复需求的嫌疑。因此,评估了邀请进行基于网络的康复需求自测作为获得医疗康复的新途径的有效性。主要问题是该干预措施是否会在22个月的随访期内导致更多的康复申请获得批准,以及在控制其他影响变量后这种效果是否也很明显。
对两个地区法定养老保险机构的8000名被保险人进行了一项随机对照研究,以检验该干预措施的有效性。干预组(IG;n = 4000)的被保险人通过邮件得知了基于网络的自测,并收到了个人访问数据(用户ID和密码)。对照组(CG;n = 4000)未收到有关自测的信息。主要结局是康复申请获批率,次要结局是无论是否获批的申请率。
两组在主要或次要结局方面没有显著差异。即使在控制了其他影响因素之后,该干预措施也无助于预测结局,但一些控制变量,如先前的康复经历,被证明是申请的重要预测因素。
养老保险机构仅仅提供康复需求自测对申请过程没有影响。因此,养老保险机构的一封信作为唯一的获取途径似乎不适合提高有意义的康复申请率。