[Quality assurance by patient surveys in medical rehabilitation: assessment and evaluation of rehabilitation structures and processes ("satisfaction of rehabilitation patients")].

Since 1994 Germany's statutory pension insurance schemes have been developing a multifaceted programme to assure and optimize the quality of their medical rehabilitation measures. One part aimed at developing a postal questionnaire for patients 8 to 12 weeks after rehab. It comprises two sections: one for the assessment of patients' perceptions and ratings in relation to rehab structures and processes, the other of changes of their health status. The article describes the development of the first part ("rehabilitee satisfaction"). We basically defined relevant sectors and qualities of medical rehab, analysing existing questionnaires, letters of complaint, results of expert interviews and patient focus groups. Mainly based on results from one large study of rehabilitees from two different pension insurance schemes (for blue or white collar workers), we report on psychometric properties of the final instrument, especially its contents, reliability, internal structure, validity and reference values. In February 1997, the instrument was accepted by the association of German pension schemes and may now be used in the routine phase of the quality programme, except for patients with psychosomatic disorders or substance abuse.