[Treatment Quality or Hotel Quality - What Determines more Rehab Satisfaction and Subjective Treatment Success in Psychosomatic Rehabilitation?]

Pub Date : 2024-11-08 DOI:10.1055/a-2430-1493
Jürgen Schmidt, Rüdiger Nübling, Udo Kaiser, Alexa Alica Kupferschmitt, Volker Köllner
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Abstract

Background: Rehab satisfaction and treatment success are firmly anchored in the German Pension Insurance's quality assurance program as quality criteria for medical rehab. In the field of psychosomatic rehab, there are hardly any studies in which the relative importance of treatment- and hotel-related characteristics for the prediction of these criteria has been investigated.

Methods: In a secondary analysis, anonymous survey data from 25 psychosomatic rehab clinics/specialist departments were analyzed. The sample comprises around 50,000 inpatient rehabilitants from 2018-2022. The surveys were conducted using a largely standardized questionnaire for the purpose of internal quality assurance. The extent to which the two outcome criteria can be predicted from 14 predictors (assessments of partial performance areas) and from a heuristic model with three blocks of variables (KV=control variables, RB=rehabilitation treatment, HL=hotel services) was examined using regression analysis.

Results: All 14 predictors correlate significantly with both criteria and can explain a total of around 67% (rehab satisfaction) resp. 40% (treatment success). In stepwise regressions, the predictors "psychotherapeutic care" and "preparing for the time after rehab" contribute most to the prediction of the criteria. Hierarchical regressions show that the incremental share of the RB block in the prediction of both criteria, i. e. the share that can be attributed with certainty to the rehab treatment variables, is many times greater than that of the hotel services.

Discussion: The hierarchical regression analyses support earlier findings that characteristics of the actual rehab care (e. g. good psychotherapeutic support) play a much greater role for the rehabilitants with regard to both outcome criteria than hotel -related features. There is much to suggest that these findings are also valid for inpatient psychosomatic acute care.

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[治疗质量还是酒店质量--是什么决定了心身康复中更多的康复满意度和主观治疗成功率?]
背景:德国养老保险质量保证计划将康复满意度和治疗成功率作为医疗康复的质量标准。在心身康复领域,几乎没有任何研究调查过治疗和酒店相关特征对预测这些标准的相对重要性:在二次分析中,对来自 25 家心身康复诊所/专科部门的匿名调查数据进行了分析。样本包括 2018-2022 年间约 5 万名住院康复者。为了保证内部质量,调查采用了基本标准化的问卷。通过回归分析,研究了14个预测因子(对部分绩效领域的评估)和包含三个变量块(KV=控制变量,RB=康复治疗,HL=酒店服务)的启发式模型对两个结果标准的预测程度:结果:所有 14 个预测因子都与这两个标准有显著相关性,总共可以解释约 67%(康复治疗满意度)和 40%(治疗成功率)。在逐步回归中,"心理治疗护理 "和 "康复后的准备 "这两个预测因子对标准的预测作用最大。分层回归结果表明,在预测这两项标准时,康复治疗区块所占的增量份额,即可以确定归因于康复治疗变量的份额,是酒店服务的好几倍:分层回归分析支持了之前的研究结果,即实际康复护理的特点(如良好的心理治疗支持)对康复者两个结果标准的作用都比与酒店相关的特点大得多。有许多证据表明,这些研究结果同样适用于住院病人的心身急性护理。
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