Quality management in medical rehabilitative care by the German statutory pension insurance scheme.

This paper aims to provide an insight into the quality management approach for medical rehabilitation services of the German statutory pension insurance scheme. In the 1990s, the German statutory pension insurance scheme initiated a quality management programme in rehabilitation, which is subject to continuous development. The main objective of implementing quality management in rehabilitative care was quality control and quality improvement. To achieve these goals, five main tools for quality measurements were applied: a classification of therapeutic services, standards of rehabilitative interventions, patient surveys, peer review, and surveys that address structure of care. These tools enable the assessment of the structural and process quality of rehabilitative care, as well as aspects of rehabilitation outcome. As a result, quality of rehabilitation care becomes more measurable, transparent, and hence can be improved on well-founded grounds. These measurements allow implementing comparisons and benchmarking of rehabilitation facilities, thereby creating incentives for quality improvements. Therefore, the development and implementation of quality management measures in facilities of inpatient and outpatient medical rehabilitation is an ongoing process and expands to other areas of rehabilitation.