权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Rehabilitation access and effectiveness cohort study for persons with back pain (REHAB-BP)

背痛患者康复途径和有效性队列研究 (REHAB-BP)

基本信息

批准号：
317621938
负责人：
Professor Dr. Matthias Bethge
金额：
--
依托单位：
Institut für Sozialmedizin und Epidemiologie
依托单位国家：
德国
项目类别：
Research Grants
财政年份：
2016
资助国家：
德国
起止时间：
2015-12-31 至 2019-12-31
项目状态：
已结题

来源：
https://gepris.dfg.de/gepris/projekt/317621938?language=en
关键词：
Rehabilitation access effectiveness cohort study

项目摘要

In cases of limited work ability or when work ability is at risk, people can apply for medical rehabilitation services. The German Pension Insurance provides these services with the aim of improving or restoring the ability to work. Musculoskeletal disease, especially back pain, is the main reason for medical rehabilitation. The appropriate access to rehabilitation according the actual needs of patients is currently under critical discussion. Frequently, the need for rehabilitation does not lead to a rehabilitation request. Despite the maxim 'rehabilitation before pension', every second person who receives a disability pension did not participate in rehabilitation services before the pension was granted. However, there are no up-to-date studies that have examined rehabilitation barriers. Moreover, randomised controlled trials that compared persons with and without rehabilitation participation have generated contradictory findings regarding the efficacy of medical rehabilitation. However, the setting of these studies was restricted to single centres or particular regions. There is currently no evidence on the effectiveness of rehabilitation services under routine conditions. The aim of our cohort study is twofold: first, to address barriers to the access to medical rehabilitation services in Germany, and second, to examine the effectiveness of German medical rehabilitation services by a propensity score matched analysis (Rehabilitation access and effectiveness cohort study for persons with back pain, REHAB-BP). The samples will be drawn from the registers of two pension insurance agencies (German Pension Insurance North: n = 22,500; German Pension Insurance Central Germany: n = 22,500). We will include employed people aged 45 to 59 years (stratified for sex and duration of sickness benefits). Persons who requested or utilised medical rehabilitation services during the past four years and persons with requested or approved disability pensions will be excluded. The baseline survey will be conducted in 2016. The questionnaire will assess the three-month prevalence of back pain, and will include a grading of pain severity and chronicity (level 0, grades I to IV). Furthermore, potential barriers to rehabilitation utilisation as well as the baseline scores of primary and secondary outcomes will be assessed. Utilisation of medical rehabilitation in 2016 and 2017 will be extracted from administrative data from the cooperating pension insurance agencies. A follow-up survey will be sent to back pain patients (grades I to IV; n = 5,760) in 2018 in order to evaluate the effects of rehabilitation utilisation (primary outcome: pain disability; secondary outcomes: e.g. pain intensity, disability days, work ability). Additionally, secondary outcomes will be extracted from administrative data (days with sickness benefits, days in employment subject to compulsory social insurance, disability pensions).

在工作能力有限或工作能力受到威胁的情况下，人们可以申请医疗康复服务。德国养恤金保险提供这些服务，目的是提高或恢复工作能力。肌肉骨骼疾病，特别是背痛，是医疗康复的主要原因。根据患者的实际需要，适当获得康复服务的问题目前正在进行重要讨论。通常，康复的需要并不导致康复请求。尽管有“先康复后养恤金”的格言，但每两个领取残疾养恤金的人中就有一个在领取养恤金之前没有参加康复服务。然而，没有最新的研究审查康复障碍。此外，随机对照试验，比较人与没有康复参与产生了矛盾的结果，关于医疗康复的疗效。然而，这些研究的设置仅限于单个中心或特定地区。目前没有证据表明在常规条件下康复服务的有效性。我们的队列研究的目的是双重的：第一，以解决障碍，获得医疗康复服务在德国，第二，检查德国医疗康复服务的有效性的倾向评分匹配分析（康复访问和有效性队列研究的人与背痛，REHAB-BP）。样本将从两家养老保险机构的登记册中抽取（德国北方养老保险：n = 22 500;德国中央养老保险德国：n = 22 500）。我们将包括45至59岁的就业人员（按性别和疾病津贴期限分层）。在过去四年中申请或使用医疗康复服务的人以及申请或批准残疾养恤金的人将被排除在外。基线调查将于2016年进行。问卷将评估三个月的背痛患病率，并将包括疼痛严重程度和慢性程度的分级（0级，I至IV级）。此外，还将评估康复利用的潜在障碍以及主要和次要结局的基线评分。2016年和2017年的医疗康复利用率将从合作养老保险机构的行政数据中提取。2018年将向背痛患者（I至IV级; n = 5，760）发送随访调查，以评估康复利用的效果（主要结局：疼痛残疾;次要结局：例如疼痛强度、残疾天数、工作能力）。此外，将从行政数据中提取次要结果（领取疾病津贴的天数、参加强制性社会保险的就业天数、残疾养恤金）。