As a result of progress in medical treatment
and changes in lifestyle in the last century, the
focus of health care has shifted from acute to
chronic disease, from cause to impact. Rehabilitation
is a specific form of treatment which
focuses on long term effects of diseases and
the prevention or reduction of disability and
thus has gained more and more importance
in modern health care. The concept of rehabilitation
and its terminology is based on the
“bio-psycho-social model of disease” and the
corresponding classification, the ICF (International
Classification of Functioning, Disability
and Health). The main feature of rehabilitation
is interdisciplinary teamwork, aiming to
achieve or at least improve the reintegration
of patients into their social and vocational
environments.
If a patient or his attending physician
think rehabilitation is necessary, a counselling
talk takes place and the insurance company
verifies that the legal conditions for treatment
at a rehabilitation centre are fulfilled.
If the medical and logistic requirements are
fulfilled, rehabilitation can be prescribed by
a SHI (statutory health insurance)-authorised
physician. If the work incapacity of an
employee is diagnosed by a occupational
physician and he considers rehabilitation
necessary, he can encourage the employee
to apply for such treatment and support the
application with medical findings and a statement.
After rehabilitation, the occupational
physician plays an important role in shortening
the time before resumption of work by
the employee.
The role of the Medical Advisers of the
Health Insurance Companies (MDK = Medizinischer
Dienst der Krankenkassen), an independent
sociomedical council of experts, is
to re-examine medial prescriptions and, if necessary,
suggest alternative treatments.
