This paper presents for the first time research results of a comprehensive analysis on stepwise occupational reintegration (SOR) provided under the German pension insurance scheme. SORs under the German pension insurance scheme directly after medical rehabilitation have recently become possible as legal changes came into force in April 2004; until then, they had been provided by the health insurance funds independent of earlier medical rehabilitation. Against the background of this amendment of the law, the present study was commissioned by Deutsche Rentenversicherung Bund to get information relative to indication, introduction, implementation and results of the new SOR procedure. Analysis of routine data from the German pension insurance scheme pertaining to more than 140 000 insured persons treated in more than 1 083 medical rehabilitation centres, as well as of more than 6 500 participant surveys, resulted in a so far unique database for investigating SOR. This database offers a comprehensive collection of data and experiences relative to the amount of SOR prescribed and realized, to participants, procedure and results of SOR under the pension insurance scheme. This amount of data has never before been available when SOR was provided by the health insurance funds. The data collected suggest pinpoint indication of SOR, a positive rating of participants and an effective contribution to reintegration into working life and prevention of premature retirement. According to the present data, medical rehabilitation centres and their recommendations have an important influence on SOR utilization. Findings suggest major differences in the recommendation behaviours of rehabilitation centres, the possibilities offered by SOR not made use of to the same degree everywhere.
The SPE-Scale is an appropriate screening instrument for hazards regarding gainful employment. It also can be recommended for use in epidemiologic or rehabilitation surveys.
The SPE scale can be recommended for further use in (rehabilitation) research. The employment of the instrument for medical appraisal has to be viewed with more caution. The percentage of subjects at risk for early retirement is largely overestimated in case of a positive test. Instruments like the SPE-scale can assist but never replace the medical appraisal.
Patients who were treated in WMR in 2014 received more work-related interventions than comparable patients in 2012 (13.5 vs. 2.5 h) and MR patients in 2014 (13.5 vs. 1.2 h). 30 min of social counselling, 180 min of work-related psychological groups and 360 min of work-related functional capacity training were realised for 93.8, 82 and 41% of the patients participating in WMR in 2014 CONCLUSION: WMR programs in Northern Germany meet the recommendations of the WMR guideline.
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