Evaluation procedures in geriatric rehabilitation programes - the perspective of the Central Medical Service of the FRG's Sickness Insurance Administration

There is evidence for the community effectiveness of preventive geriatric i ntervention programs prior to the need for help or long-term care from a co uple of prospective randomized controlled trials (RCTs). For geriatric reha bilitation programs tailored to older people with imminent or manifest need for long-term care analogous evidence is still lacking. The nationwide lea ding boards of the FRG's Sickness Insurance Administration in conjunction w ith its. Central Medical Service have formulated guidelines for the formati on of a nationwide ambulatory geriatric rehabilitation service to realize t he postulate of the long-term car insurance legislation "rehabilitation pri or to longterm care". These guidelines must be proven empirically. To prove the effectiveness and efficiency of the foreseen ambulatory geriatric reha bilitation service, the RCT design would be highly desirable. Unfortunately , the prerequisites in the field of methodology are poor since valid, repro ductible and feasible criteria for the selection of suitable patients and m easurement criteria which meet the requirement of proven medium-term sensit ivity to change do not yet exist. Nevertheless, there is a great and urgent need, for the first time, to investigate the cost-effect effectiveness rat io for this ambulatory geriatric rehabilitation service to be established i n the FRG, leaving aside the methodologic desiderata of randomized control- groups.