1 Inpatient and outpatient rehabilitation in Germany. Current state and further development

The rehabilitation of patients with diseases of the musculoskeletal system and injuries has a high priority in Germany. The costs are essentially borne by the statutory health insurance companies (reha before nursing), pension schemes (reha before pension) and German statutory accident insurance. The necessity for rehabilitation and the derivation of objectives and rehabilitation strategies are based on the international classification of functioning, disability and health (ICF). Medical rehabilitation is increasingly being supplemented by options from medical occupational rehabilitation. Against the background of a predicted reduction in the work force due to the age structure of the population and the associated problem of financing of pensions, people must remain longer in occupations. The increase in the elderly population results in more wear and age-related diseases, such as osteoporosis and arthrosis as well as typical age-related injuries and sequelae. This will place increasing demands on the curative and rehabilitation sectors. Maintaining the ability to work and independence results in an increase in the need for rehabilitation; however, this also necessitates an adaptation of processes and structures in order to be able to meet these challenges.