Scientific background

In Germany, medical rehabilitation is carried out in inpatient or outpatient form, or in a combination of both modalities. Rehabilitation, according to the guidelines of the statutory pension insurance, aims to enable insured persons to participate in working life again after acute or chronic illnesses. For this purpose, a differentiated spectrum of rehabilitative offers is available, which, depending on the indication, can range from multimodal inpatient or outpatient rehabilitation to special vocational support measures. The overriding principle here is that, before a pension is granted, an attempt should first be made to eliminate an impairment of earning capacity that has already occurred or is imminent, or to alleviate it to such an extent that premature retirement from working life can be prevented or postponed ("rehab before pension").

Because of the particular medical as well as health economic implications of chronic diseases, prevention and medical rehabilitation are becoming increasingly important for efficient health care. Psychological and psychosomatic factors have been shown to play a major role in the processes that are decisive for the development and maintenance of chronic diseases, which is why psychosomatic rehabilitation in particular has become a mainstay of psychosocial care in Germany.

In Germany, medical rehabilitation is one of the best-studied areas of medical care. This is due not only to the quality assurance programs of the German Pension Insurance, but also to the close cooperation of the rehabilitation facilities with regional and supraregional research associations. In comprehensive annual publications, which are accessible to a broad (specialist) public free of charge (e.g., via various Internet portals of the German Pension Insurance Association), all essential performance and care data of the German Pension Insurance are presented.

In 2021, Deutsche Rentenversicherung performed a total of 1,018,129 medical rehabilitations. Of these, inpatient psychosomatic rehabilitation specifically accounted for 140,921 cases and outpatient psychosomatic rehabilitation for 9,262 cases. Of these, affective disorders represent the most common initial diagnosis at approximately 56%, followed by neurotic, stress and somatoform disorders at 31%. In the same period, a total of 165,824 pensions for reduced earning capacity were paid out, of which around 41.5% were due to psychological or psychosomatic disorders.