Type of Project: Funded project Joint project Study
Health status, rehabilitation needs, rehabilitation needs, and rehabilitative services in a cohort of LVA-insured persons

Background: Recent legal regulations have led to a change in the application and approval behavior in the field of rehabilitation by the statutory pension insurance. In this situation it is particularly important to survey "under" the surface of rehabilitative care the true prevalence and incidence of objectifiable rehabilitation needs and subjective rehabilitation needs. Aims and objectives: The aim of the project was to epidemiologically determine the rehabilitation needs of currently employed LVA-insured persons for the indication areas dorsopathies (ICD9 721-724) and/or functional complaints of internal medicine (corresponding to ICD9 306). At the same time, the subjective rehabilitation needs of the insured were surveyed. In addition, documentation of the rehabilitative care actually provided during the study period was carried out. Study design: The sample includes all 10,009 working LVA-insured persons aged 40 to 54 years from the city of Lübeck and immediate surroundings. People who had indicated severe back pain in a postal screening questionnaire or who scored high on the somatization scale of the SCL90R were invited for a medical examination. Results: Completed questionnaires were returned by 5,211 subjects (response rate = 57.9%). 772 subjects were excluded because they did not meet defined inclusion criteria. Of the remaining 4,439 subjects, 802 were invited for medical examination; 527 actually appeared for examination, including 335 for severe back pain. Severe back pain among LVA insureds is often further burdened by other complaints such as concomitant diseases and risk factors. Raspe (2001) therefore proposes a staging model based on the extent of "amplification" of back pain. It includes components of temporal and spatial spread of back pain as well as concomitant physical complaints. Based on clinical judgements, 74 of those examined with severe back pain were identified as needing rehabilitation. In terms of responders, this means that an estimated 2.5% had a current rehabilitation need for dorsopathies. Research Network Northern Germany