Outpatient provision
The ambulatory care services in accredited spas belong to § 23 para. 2 SGB V to the medical benefits provided by the German health insurance are accepted. Outpatient preventive services serve to " eliminate a weakening of health that would likely lead to an illness in the foreseeable future , to counteract a risk to the health development of a child, to prevent illnesses or to prevent them from worsening or to avoid the need for long-term care " is medically necessary and outpatient medical treatment and a supply of medicines, bandages, remedies and aids are not sufficient.
Individual measures
Outpatient preventive services include medical advice and motivation and the necessary treatment. Physical therapy measures including massages , mud packs and local spa treatments , such as baths in medicinal springs, as well as movement and relaxation exercises . Therapies for preventive measures can be activating measures such as physiotherapy and sport, physiotherapy , occupational therapy , swimming , treading water or terrain cures. In addition, reactive measures of balneo-physical therapy are offered, paying special attention to local remedies , as well as behavioral training for risk factors in group and individual therapies by changing diet and dealing with everyday drugs ( nicotine , alcohol ).
Outpatient care benefits (outdated: cure)
If the outpatient, local measures are not sufficient, outpatient preventive services in recognized health resorts can be considered. Corresponding ordinances must be checked by the medical service of the health insurance companies before they are approved by the health insurance company . The measure formerly known as an open spa treatment is now referred to as an outpatient preventive measure .
In the case of an outpatient preventive measure, the patient can largely freely choose the therapy facility with the doctor and organize his stay in the spa himself. The respective applications are then selected together with the spa doctor , such as mud baths , physiotherapy , massages or hay pads.
The patient takes care of his own accommodation. Outpatient measures are paid for by the responsible health insurance company or benefit agency . As a rule, there is a 3-year period to be observed before a new pension can be applied for.
The so-called compact cure is a special form of outpatient preventive care . A compact cure follows a holistic approach. Not only are the main symptoms treated, but also their causes such as obesity or incorrect movements. This also includes accompanying psychological support in order to accept the illness and deal with it.
Assumption of costs
The costs of medical treatment are covered in full and 90% of the therapy costs are covered by the service provider. For the other costs such as accommodation, meals and travel costs, the health insurance company can grant a flat-rate subsidy of a maximum of 16 euros per day. For chronically ill small children, the grant can be increased to up to 25 euros. As a rule, a preventive measure lasting 3 weeks is approved. An extension is possible if medically necessary and specifically justified. During the outpatient preventive measure, one is considered fit for work and is therefore not on sick leave. As a rule, it is therefore necessary to use vacation days for an outpatient measure.
Indication
- Functional and regulatory disorders
- Compensated, chronic diseases
- Behavioral changes in chronic diseases and risk factors
aims
- Improvement of performance
- Function and regulation training
- Adapting behavior to existing chronic diseases and disabilities
- Developing compensatory skills and strengths
- Relief and elimination of pain symptoms
- Health training with advice and discussions on a health-conscious lifestyle, especially to overcome risk factors by changing lifestyle
- Helping people help themselves
Effectiveness, economy
A dissertation comes to the result that an outpatient cure "only causes minimal costs ... with approximately comparable effect sizes ... as in inpatient healing procedures. [P. 60] Here the effect sizes reflect the effectiveness of the measure.
See also
Individual evidence
- ↑ § 23 Paragraph 5 SGB V
- ↑ Continued payment of remuneration - outpatient cure (BAG, judgment of May 25, 2016, 5 AZR 298/15) ( page no longer available , search in web archives ) Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice.
- ↑ Dissertation Munich 2012, LMU Munich: Effect sizes and therapy costs in outpatient cures for patients with LSW syndrome in Bad Füssing. Retrieved October 6, 2018 .
