[Outcome assessment in geriatric trauma]

[Inpatient and outpatient rehabilitation in Germany. Current state and further development]

BACKGROUND

The rehabilitation of patients with diseases of the musculoskeletal system and injuries has a high priority in Germany. The costs are essentially borne by the statutory health insurance companies (reha before nursing), pension schemes (reha before pension) and German statutory accident insurance.

OBJECTIVES

The necessity for rehabilitation and the derivation of objectives and rehabilitation strategies are based on the international classification of functioning, disability and health (ICF). Medical rehabilitation is increasingly being supplemented by options from medical occupational rehabilitation.

DEMOGRAPHIC DEVELOPMENT

Against the background of a predicted reduction in the work force due to the age structure of the population and the associated problem of financing of pensions, people must remain longer in occupations. The increase in the elderly population results in more wear and age-related diseases, such as osteoporosis and arthrosis as well as typical age-related injuries and sequelae. This will place increasing demands on the curative and rehabilitation sectors.

CONCLUSION

Maintaining the ability to work and independence results in an increase in the need for rehabilitation; however, this also necessitates an adaptation of processes and structures in order to be able to meet these challenges.

[Rehabilitation in orthopedics and trauma surgery. State of the art]

Diseases and injuries of the musculoskeletal system are the most common reasons for rehabilitation in Germany. The statutory health insurance, pension funds and the German social accident insurance are service providers for rehabilitation. Rehabilitation is based on the international classification of functioning, disability and health (ICF). The extensive possibilities for medical rehabilitation are increasingly being supplemented by options for combined medical and occupational rehabilitation. The demographic changes in Germany are also a challenge for rehabilitation. In a situation of predicted labor deficit, even now it becomes essential to keep employees longer in their jobs. The increasing number of elderly persons causes an increase in frequent age-dependent diseases, such as osteoporosis and osteoarthritis in combination with age-dependent injuries. This will be a burden for the health system in acute care medicine and rehabilitation. Improving activities and participation following diseases and injuries of the musculoskeletal system will end in an increase in utilization of rehabilitation. This needs to be considered and reflected in an adjusted higher budget for costs in rehabilitation.