QUALITY MANAGEMENT IN REHABILITATION

In the context of the quality assurance program of the German pension insurance, institutions, instruments and procedures have been develope d in the past :Few years in order to assess the quality of structure, process, and results of inpatient rehabilitation, as well as patient s atisfaction. The routine implementation of these procedures aims at pr oviding rehabilitation hospitals with fast information on shortcomings in their current practice, so that concepts of treatment and - in the long run - effects of rehabilitation can be systematically improved. When the ''quality profiles'' of rehabilitation hospitals are compared (''benchmarking''), paying institutions of rehabilitation could gain information on the cost-quality-ratio of particular hospitals as well as important leads for improving the steering processes of patients an d hospitals. In the present article, results of a first ''field-run'' of the procedures for measuring patient satisfaction and quality of re habilitation processes are reported. A comparative analysis of patient satisfaction in four orthopaedic/rheumatologic rehabilitation hospita ls showed high degrees of overall satisfaction in all hospitals. In se veral subdimensions of patient satisfaction, however, significant diff erences between hospitals were found. Quality of rehabilitation proces ses - as assessed by a standardized peer-review - varied substantially between 36 hospitals. Problems of quality were found especially in so me dimensions that must be considered as crucial for rehabilitation, e .g., in the history and diagnosis of disabilities, in the consideratio n of psyche-social problems, or in the assessment of occupational capa cities.